Could pyridoxine supplements be used to ameliorate behavioural and neuropsychiatric side effects of epileptic children on levetiracetam? A local experience from a case series of epilepsy patients at Luton and Dunstable University Hospital UK
No Thumbnail Available
Authors
El Gamal, M
Gandhi, V
Stevens, L
Rao, T.S
Issue Date
2022
Type
Scientific Paper
Language
Keywords
Research Subject Categories::MEDICINE::Dermatology and venerology,clinical genetics, internal medicine::Internal medicine::Paediatric medicine
Alternative Title
Abstract
Poster 078
Could pyridoxine supplements be used to ameliorate behavioural and neuropsychiatric side effects of epileptic children on levetiracetam? A local experience from a case series of epilepsy patients at Luton and Dunstable University Hospital UK
M EL GAMAL, V GANDHI, L STEVENS, TS RAO
Luton and Dunstable Hospital, Bedfordshire Hospitals NHS Trust, Luton, UK
Objective: Levetiracetam is one of the most common anti-epileptic drugs (AEDs) prescribed across all age groups due to its proved efficacy against multiple types of seizures, in addition to its tolerability, safety, and quick titration. However, various neuropsychiatric adverse events (NPAEs) have been reported with its use that could necessitate early discontinuation of the drug. Based on previous published literature that suggests possible efficacy of pyridoxine supplements in controlling levetiracetam related NPAEs, we are presenting a case series of 6 patients who have been commenced on pyridoxine in a trial to relieve levetiracetam related NPAEs instead of stopping the drug.
Methods: We have retrospectively analyzed electronic clinical records of 6 epilepsy patients who have been initiated on pyridoxine, when NPAEs have been reported on levetiracetam, as a case cohort of paediatric epilepsy patients at a district general hospital. Reported NPAEs related to levetiracetam were mood swings, hyperactivity, disturbed sleep and aggressiveness with a dose ranging from (25–38mg/kg/d). We gathered results of subjective feedback from parents about response in their behavior, 2–3 weeks after starting pyridoxine supplements with a dose ranging from (25–100mg/d).
Results: All of the 6 patients have positively responded with improvement in these behavioral symptoms after commencing of pyridoxine supplements. One of them did not improve with the lower dose of 50mg/d, but then started to show improvement on a higher dose of 100mg/d. There were no treatment related side effects from pyridoxine.
Conclusions: Pyridoxine supplementation has shown positive effect in most of our patients in improving the unwanted NPAE of levetiracetam, supporting findings of previous published reports. However, better evidence with high quality studies are required to explore the potential role of pyridoxine in management of NPAE related to different AEDs.
Description
Citation
El Gamal, M., Gandhi, V., Stevens, L., Rao, T. S. (2022) Could pyridoxine supplements be used to ameliorate behavioural and neuropsychiatric side effects of epileptic children on levetiracetam? A local experience from a case series of epilepsy patients at Luton and Dunstable University Hospital UK. Developmental Medicine and Child Neurology. 64(Suppl 1): 41. DOI: https://dx.doi.org/10.1111/dmcn.15123