A Study on the Emotional and Behavioral Side Effects Associated with Brivaracetam versus Levetiracetam in Pediatric Population with Epilepsy

Excerpt

To the Editor: Epilepsy is a prevalent brain disorder characterized by recurrent seizures [1], affecting 0.5%-1% of adults and 0.35%-0.55% of children in India [2]. This study compares the behavioral and emotional side effects of levetiracetam (LEV) and brivaracetam (BRV) in the pediatric population. This retro-prospective observational study was conducted at the Department of Psychiatry and Department of Pediatric Neurology in Amrita Institute of Medical Sciences and Research Centre, Kochi. The study included 43 pediatric patients under 16 year diagnosed with seizures among which, 24 were on LEV and 19 on BRV. Data were collected from medical records and analysed using IBM SPSS version 20.0, with significance set at p < 0.05. The Paediatric Symptom Checklist-17 (PSC-17) was used to assess behavioral and emotional states. Patients on BRV exhibited significantly lower PSC-17 scores in internalizing (0.58 vs. 2.96), attention (2.05 vs. 4.58), and externalizing domains (1.0 vs. 2.5) compared to those on LEV. LEV patients showed higher behavioral side effects, including depression, aggression, and attention deficits. The findings from our study are consistent with those of a Spanish study [3]. BRV at the SV2A binding site supports our observation that BRV has a more favourable side effect profile [4]. BRV patients had a lower relapse rate and fewer behavioral issues, enhancing their overall quality of life. BRV demonstrated superior efficacy and a better safety profile compared to LEV, with fewer behavioral and emotional side effects in pediatric epilepsy patients. These findings suggest BRV as a more favourable treatment option, emphasizing the need to consider both therapeutic and psychological outcomes in epilepsy management. …