Levetiracetam for Treatment-Refractory Posttraumatic Stress Disorder.
J Clin Psychiatry 2006;67(2):211-214
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: To assess the use of levetiracetam,
a novel anticonvulsant agent, in the treatment of
refractory posttraumatic stress disorder (PTSD).
Method: Retrospective analysis was conducted of
23 patients with DSM-IV diagnosis of PTSD who,
after being deemed partial or nonresponders to
antidepressant therapy, received levetiracetam in a naturalistic
fashion. The primary outcome measure was the PTSD
Checklist-Civilian Version (PCL-C). Secondary outcome
measures included the Hamilton Rating Scale for Anxiety
(HAM-A), the Hamilton Rating Scale for Depression
(HAM-D), Clinical Global Impressions-Severity of Illness
scale (CGI-S), and Clinical Global
Impressions-Improvement scale (CGI-I).
Results: Levetiracetam at a mean ± SD dose
of 1967 ± 650 mg/day for 9.7 ± 3.7 weeks was generally
well tolerated. Nineteen patients (83%) were taking at least
1 concomitant medication. Patients were severely ill
with a mean baseline PCL-C score of 67.2 ± 9.4, CGI-S
score of 6.0 ± 0.7, and HAM-A score of 26.8 ± 4.9. Patients
improved significantly on all measures (p < .001).
Thirteen patients (56%) met responder criteria at endpoint
(PCL-C mean change = 23.5, CGI-I score < = 2), and 6
(26%) met remission criteria (CGI-S score < = 2).
Adverse events were generally mild, and no patients
discontinued levetiracetam because of side effects.
Conclusion: These preliminary data suggest
that levetiracetam may be an effective treatment in
combination with antidepressant therapy for patients with
PTSD who remain symptomatic after initial intervention.