http://www.ivillagehealth.com/news/topnews/content/0,,418445_582630,00.html

Side effect risk from drug higher in epileptics

By Alison McCook

Last Updated: 2003-05-30 11:00:26 -0400 (Reuters Health)

NEW YORK (Reuters Health) - New research suggests that people with epilepsy who receive an anti-seizure drug may be more likely to experience certain side effects than patients with anxiety and dementia who are sometimes treated with the same medication.

The investigators found that, among people who received the drug levetiracetam (Keppra), feelings of depression, hostility, anxiety and nervousness appeared more commonly in people with epilepsy than in people with dementia or anxiety.

This finding "suggests that people with epilepsy have a higher rate of side effects than patients with disorders that you would expect to have these problems," study author Joyce A. Cramer of Yale University in Connecticut told Reuters Health.

Cramer noted that research suggests other anti-epilepsy drugs besides levetiracetam can also produce similar side effects in people with epilepsy.

She cautioned, however, that the rate of anxiety, depression and other similar side effects was very low, even in epileptics. Furthermore, for anyone who experiences these side effects, their doctor can often change the dose or tell them to stop taking the drug, she noted.

She said that any doctor who treats a patient with epilepsy is likely very careful, and probably needs to take no extra precautions when prescribing anti-seizure drugs to a patient with epilepsy than when offering the medications to other patients.

"What the data showed is that these things are very rare," Cramer said in an interview.

"I think the vast, vast majority of (epileptics) have no trouble starting any drug," Cramer said.

To obtain their findings, Cramer and her colleagues reviewed past studies that compared the effects of levetiracetam to a placebo in patients with epilepsy, anxiety and cognitive disorders -- primarily, dementia.

The current report, published in the journal Epilepsy and Behavior, includes information collected from 2,416 epilepsy patients, 1,510 people with an anxiety disorder and 719 people with cognitive disorders.

Pooling this data, Cramer and her team saw that between two and four percent of people with epilepsy reported feelings of depression, nervousness, hostility and anxiety, rates that exceeded those found in placebo-treated patients and patients with anxiety or cognitive disorders who received levetiracetam.

Cramer said that levetiracetam-treated epileptic patients also showed a slightly higher risk of psychotic or suicidal behaviors, but that the rates of these behaviors were very low.

In terms of why epileptics might experience more side effects, Cramer suggested that the brains of people with epilepsy might contain differences that allow medications to bring out certain side effects more strongly.

Epileptics "seem to be more sensitive to these drugs," she said.

The study was supported by UCB Pharma, which makes Keppra.

Copyright 2002 Reuters.