PURPOSE: The rate of brivaracetam-related behavioral adverse events is a current focus of discussion. This study aims to assess the effect of brivaracetam on anger levels in patients with epilepsy, adjusted by mood symptoms, history of psychiatric disorders, and seizure response.
METHOD: Prospective analysis of 37 patients assessed for anger levels (STAXI-2), depression-anxiety (HADS) and quality of life (QOLIE-10) before adjunctive brivaracetam treatment and reassessed 3-6 months later. A control group following the same protocol of assessment was used for 1:1 comparison. A high percentage of mood stabilizers were included in this control group.
RESULTS: Brivaracetam was indicated for patients including focal onset (79%) and generalized epilepsy (21%). Nearly 60% of responders and no psychiatric adverse events were found. This was similar to controls. The overall results revealed that brivaracetam was associated with better in anger levels, mood scores and quality of life at baseline. Prior use of levetiracetam or the presence of a psychiatric background did not influence the results. However, improvements in anger levels were seen in the brivaracetam responders.
CONCLUSION: This study shows that brivaracetam is not associated with an increased level of anger in patients with either focal or generalized epilepsy in the absence of psychiatric comorbidity. However, an improvement in anger levels is possibly influenced by a good seizure response.