Cross-sensitivity of psychiatric and behavioral side effects with antiepileptic drug use

Baibing Chen, Hyunmi Choi, Lawrence J. Hirsch, Alexander Legge, Richard Buchsbaum, Kamil Detyniecki

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Purpose: To determine rates of cross-sensitivity of intolerable psychiatric and behavioral side effects (IPBSEs) among commonly used antiepileptic drugs (AEDs) in adult patients with epilepsy. Methods: IPBSE was defined as a psychiatric or behavioral side effect attributed to AED use that led to a decrease in dose or cessation of an AED. Cross-sensitivity was calculated and was defined as the likelihood of developing IPBSE to a specific AED given IPBSE to another AED. Our sample consisted of 2312 adult patients that were prescribed 2 or more AEDs. Non-AED confounders and were controlled for in all analyses. Results: Among the 2312 patients, 20.2% of patients who had taken at least 2 AEDs had IPBSE(s) attributed to at least one AED; 3.5% had IPBSE to two or more AEDs. History of treated depression and psychosis were found to be significant predictors (p < 0.001) of developing IPBSE and were controlled for in all AED-specific analyses. Cross-sensitivity was seen between LEV and ZNS (p < 0.001). There was a significant increase in odds of experiencing IPBSE to LEV (41.5%; OR = 2.7; p < 0.001) or ZNS (22.1%; OR = 3.5; p < 0.001) given a patient had IPBSE to another AED compared to having no IPBSE to other AEDs (20.5% and 7.5%, respectively). Conclusion: History of depression and psychosis increased risk of developing IPBSE to AEDs. The probability of experiencing IPBSE increased for a patient taking LEV or ZNS if the patient experienced IPBSE to another AED. Our results may be clinically useful for predicting IPBSE associated with certain AEDs.

Original languageEnglish (US)
Pages (from-to)38-42
Number of pages5
StatePublished - Nov 2018
Externally publishedYes


  • Anticonvulsant
  • Depression
  • Levetiracetam
  • Psychosis
  • Seizure
  • Zonisamide

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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