ReviewBehavioural neurology2018
Mechanisms Underlying Aggressive Behavior Induced by Antiepileptic Drugs: Focus on Topiramate, Levetiracetam, and Perampanel.
Review in Behavioural neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 1 synthesis or guideline pooled it, 121 citations in OpenAlex.
- Psychiatric Comorbidities in Pediatric Epilepsy.Current psychiatry reports · 2020Pooled it
- Pharmacokinetics and bioequivalence evaluation of two oral formulations of topiramate tablets in healthy Chinese male volunteers under fasting and fed conditions.Naunyn-Schmiedeberg's archives of pharmacology · 2025Trial
- Perampanel as monotherapy or first adjunctive therapy in pediatric and adult patients with epilepsy: the first United States-based phase IV open-label ELEVATE study.Journal of neurology · 2024Trial
- Risk of drug-related aggression in pediatric populations: a pharmacovigilance analysis using the FAERS database.Frontiers in pediatrics · 2026Article
- Examining aggressive behavior in patients with epilepsy under treatment with Levetiracetam, Brivaracetam and Perampanel: a comparison to healthy controls.Frontiers in behavioral neuroscience · 2026Article
- Article
- Psychiatric and behavioural side effects of antiseizure medications in epilepsy.Journal of neurology · 2025Review
- Computational drug repositioning approach to predict multi-target therapeutics for epilepsy.Scientific reports · 2025Article
- Pharmacogenetics of anti-seizure medications in Arab countries: a comprehensive review.Future science OA · 2025Review
- Article
- Perampanel-associated exacerbation of de novo psychosis and lateralized rhythmic delta activity: A case report.PCN reports : psychiatry and clinical neurosciences · 2025Article
- Beyond Seizure Control: A Case Series on Levetiracetam Associated Psychiatric Manifestations.Indian journal of psychological medicine · 2025Article
- Prevalence, clinical characteristics, and risk factors for psychosis in people with epilepsy: A multicenter retrospective cohort study.Epilepsia · 2025Article
- Perioperative Management of Patients With Seizure Disorders: Part I.Anesthesia progress · 2025Review
- Psychiatric disorders with antiseizure medications in children: an analysis of the FDA adverse event reporting system database.Acta epileptologica · 2025Article
- Drug-Induced Cognitive Impairment.Drug safety · 2025Review
- Treatment of Seizures in People with Intellectual Disability.CNS drugs · 2025Review
- Levetiracetam Induced Behavioural Changes in an Adult Female Patient: A Case Report.Current drug safety · 2025Article
- The real-world safety of lacosamide and perampanel in children: a disproportionality analysis of the FDA Adverse Event Reporting System.Therapeutic advances in drug safety · 2025Article
- Clinical factors associated with perampanel retention, response, seizure freedom and tolerability: real-world evidence from the PERMIT Extension study.Therapeutic advances in neurological disorders · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Antiepileptic drugs (AEDs) are effective against seizures, but their use is often limited by adverse effects, among them psychiatric and behavioral ones including aggressive behavior (AB). Knowledge of the incidence, risk factors, and the underlying mechanisms of AB induced by AEDs may help to facilitate management and reduce the risk of such side effects. The exact incidence of AB as an adverse effect of AEDs is difficult to estimate, but frequencies up to 16% have been reported. Primarily, levetiracetam (LEV), perampanel (PER), and topiramate (TPM), which have diverse mechanisms of action, have been associated with AB. Currently, there is no evidence for a specific pharmacological mechanism solely explaining the increased incidence of AB with LEV, PER, and TPM. Serotonin (5-HT) and GABA, and particularly glutamate (via the AMPA receptor), seem to play key roles. Other mechanisms involve hormones, epigenetics, and "alternative psychosis" and related phenomena. Increased individual susceptibility due to an underlying neurological and/or a mental health disorder may further explain why people with epilepsy are at an increased risk of AB when using AEDs. Remarkably, AB may occur with a delay of weeks or months after start of treatment. Information to patients, relatives, and caregivers, as well as sufficient clinical follow-up, is crucial, and there is a need for further research to understand the complex relationship between AED mechanisms of action and the induction/worsening of AB.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.