Revisiting the Association Between Levetiracetam and Psychiatric Symptoms in People With Epilepsy

This letter comments on the recent study by Gammoh et al examining the relationship between psychiatric symptoms and levetiracetam use in people with epilepsy. While the study addresses an important clinical issue, several methodological considerations may influence the interpretation of the findings. These include the limitations of the crossectional design, the lack of adjustment for baseline psychiatric history, and the reliance on self-reported screening instruments. In addition, the conclusion that levetiracetam is not associated with psychiatric symptoms should be interpreted cautiously in light of existing literature reporting heterogeneous but clinically relevant psychiatric adverse effects. Further longitudinal studies incorporating baseline psychiatric assessment are needed to better clarify this relationship.