Levetiracetam as Adjunctive Therapy for Refractory Anxiety Disorders
J Clin Psychiatry 2007;68(7):1010-1013
© Copyright 2016 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: Anxiety disorders are the most prevalent psychiatric disorders as a group, and despite the effectiveness of currently available treatments for anxiety, many patients (40%-65%) remain symptomatic after initial intervention. Thus, there is a significant need for efficacious pharmacologic agents that are safe and well tolerated and lead patients to remission of symptoms. We present a retrospective analysis that assessed the efficacy and tolerability of adjunctive levetiracetam, a novel anticonvulsant agent, in the treatment of refractory anxiety.
Method: Forty patients with DSM-IV anxiety disorders, who were deemed partial responders or nonresponders to anxiolytic therapy, received adjunctive levetiracetam in a naturalistic fashion during the time period from January 2004 through December 2004. We conducted a retrospective chart review. The primary outcome measures were the Clinical Global Impressions-Severity of Illness (CGI-S) scale and the Clinical Global Impressions-Improvement (CGI-I) scale. Mean change from baseline to endpoint was assessed using 2-tailed paired t tests.
Results: Levetiracetam at a mean ± SD dose of 1969 ± 819 mg/day for a mean ± SD time period of 9.3 ± 5.1 weeks was generally well tolerated. Patients were markedly ill with a mean ± SD baseline CGI-S score of 6.2 ± 0.6. Patients improved significantly, with an endpoint CGI-S score of 4.2 ± 1.8 (p < .001) and CGI-I score of 2.6 ± 1.2. Adverse events were generally mild, and only 4 patients discontinued levetiracetam because of side effects.
Conclusion: These preliminary data suggest that levetiracetam may be an effective adjunctive treatment for patients with anxiety disorders who remain symptomatic despite initial anxiolytic therapy.