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Safety and Efficacy of Levetiracetam for Patients With Panic Disorder: Results of an Open-Label, Fixed-Flexible Dose Study

J Clin Psychiatry 2006;67(10):1573-1576

Objective: To examine the safety and efficacy of the anticonvulsant levetiracetam in the treatment of patients with panic disorder.

Method: In an open-label, fixed-flexible dose study, 18 patients with panic disorder with or without agoraphobia (DSM-IV diagnostic criteria) were treated with levetiracetam for 12 weeks. Outcome was assessed with standard rating instruments (Clinical Global Impressions-Severity of Illness scale [CGI-S], Clinical Global Impressions-Improvement scale [CGI-I], and the 14-item Hamilton Rating Scale for Anxiety [HAM-A]) and by the number of panic attacks during the previous week. The study was conducted in 2 outpatient clinics in New York City from January 2004 through July 2005.

Results: Of the 13 patients completing the study, 11 were rated "very much" or "much" improved on the CGI-I. Panic attack frequency, anxiety (HAM-A), and global severity (CGI-S) ratings also demonstrated significant improvement (all p < .00). For most patients, clinical benefits were apparent after only 1 to 2 weeks of treatment. Levetiracetam was well tolerated with minimal side effects.

Conclusion: Given its favorable pharmacokinetics, side effect profile, and, if confirmed, early onset of action and efficacy, levetiracetam might represent significant progress in the pharmacologic management of panic disorder.