Levetiracetam induces severe psychiatric symptoms in people with epilepsy.

• 111 (7.8%) of 1412 patients taking levetiracetam had severe psychotic disorders. • Some patients also showed suicidal and self-harm behaviors. 3 reducing or stopping the drug to control symptoms were necessary. • Psychiatric symptoms caused by levetiracetam require high attention. : Drug-induced psychiatric symptoms are an important cause of treatment failure. Worldwide, levetiracetam has been widely used to treat epilepsy; however, associated psychobehavioral abnormalities have been observed. This study aimed to characterize levetiracetam-induced severe psychiatric symptoms and to propose preventive and therapeutic measures. : In this retrospective cluster sampling study, psychiatric symptoms of patients who had taken levetiracetam for at least 1 month were analyzed. : 111(7.8%) of the 1,412 included patients exhibited severe psychiatric symptoms. Hallucinations, delusions, aggressive behavior, and agitation were the most common manifestations. Some patients also showed suicidal and self-harm behaviors. These symptoms were mainly controlled by reducing the dose of levetiracetam, stopping the drug, or adding antipsychotic drugs to the treatment regimen. : The severe psychiatric symptoms caused by levetiracetam require special attention. [ABSTRACT FROM AUTHOR]