levetiracetam and Disruptive--Impulse-Control--and-Conduct-Disorders

There are few controlled studies evaluating drug treatment for impulsive aggression. The objective of this study was to evaluate levetiracetam in patients with impulsive aggression, and whether diagnosis or other baseline characteristics predict response.. Outpatients with clinically significant impulsive aggression (meeting Coccaro et al. revised criteria for intermittent explosive disorder), without other psychiatric symptomatology clearly requiring treatment, were randomly assigned to levetiracetam or placebo, double-blind, for 10 weeks, at a variable dose with a maximum dose of 3000 mg/day. The primary efficacy measure was change in the total aggression score from the revised Overt Aggression Scale-Modified. The study was conducted from September 2005 to July 2006.. Of 40 patients (20 in each treatment group), 34 completed at least 4 weeks of treatment with double-blind medication. There was no overall statistical evidence of levetiracetam benefit, and no subgroup more responsive to levetiracetam could be identified.. Levetiracetam was not as efficacious as oxcarbazepine was in a prior similar study. Additional studies of medications for impulsive aggression seem warranted.

Topics: Adult; Aggression; Disruptive, Impulse Control, and Conduct Disorders; Double-Blind Method; Female; Humans; Impulsive Behavior; Levetiracetam; Male; Middle Aged; Patient Selection; Piracetam; Treatment Failure

The objectives of this study were to determine whether autistic children taking levetiracetam (1) showed improvement in the areas of aggression, impulsivity, hyperkinesis, and mood instability, and (2) showed a nootropic response. Ten white autistic boys ranging from 4 to 10 years were compared pretreatment and while taking levetiracetam for an average of 4.1 weeks. Inattention, hyperkinesis, and impulsivity were evaluated using the Achenbach Attention Problems scale, Conners DSM-IV Total scale, and the Conners Attention-Deficit Hyperactivity Disorder Index scale, all of which showed statistically significant improvements. Mood instability was measured with the Conners Global Index (CGI) Emotional Lability and CGI Total scales, both of which showed statistically significant improvements. Aggressive behavior, as measured with the Achenbach Aggression scale, showed statistically significant improvement only for subjects who were not recently weaned from medications that reduce aggression (e.g., risperidone, carbamazepine, desipramine). Levetiracetam may reduce hyperactivity, impulsivity, mood instability, and aggression in autistic children with these problems. No nootropic effect was observed.

Topics: Aggression; Anticonvulsants; Autistic Disorder; Cetirizine; Child; Child Behavior Disorders; Child, Preschool; Disruptive, Impulse Control, and Conduct Disorders; Drug Therapy, Combination; Histamine H1 Antagonists; Humans; Hyperkinesis; Incidence; Levetiracetam; Male; Nootropic Agents; Piracetam; Prospective Studies; Surveys and Questionnaires; Valproic Acid