Levetiracetam in Patients With Impulsive Aggression: A Double-Blind, Placebo-Controlled Trial

Jeffrey A. Mattes, M.D.

Objective: 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.

Method: 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.

Results: 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.

Conclusions: Levetiracetam was not as efficacious as oxcarbazepine was in a prior similar study. Additional studies of medications for impulsive aggression seem warranted.

(J Clin Psychiatry 2008;69:310-315; online ahead of print January 23, 2008)

Received Feb. 7, 2007; accepted Oct. 2, 2007. From the Psychopharmacology Research Association of Princeton, Princeton, N.J.

Funding support from UCB Pharma.

Dr. Mattes reports no additional financial or other relationship relevant to the subject of this article.

Corresponding author and reprints: Jeffrey A. Mattes, M.D., Psychopharmacology Research Association of Princeton, 601 Ewing St., Suite A-12, Princeton, NJ 08540 (e-mail: jmattesmd@verizon.net).