LAUSR

The term ‘‘psychosis’’ comes from the Greek prefix ‘‘ o’’ (‘‘soul’’ or ‘‘mind’’) and suffix ‘‘ -’’ (‘‘abnormal condition’’).1 It is used to describe an altered mental state characterised by loss of the ability to differentiate between inner mental experiences and the external reality.2 Epileptic patients frequently present psychiatric comorbidities, including psychotic disorders.3—6 Levetiracetam-induced psychosis affects 1%-1.3% of all patients treated with this antiepileptic drug (AED), and represents a diagnostic and therapeutic challenge.3,7,8 Several risk factors for AEDinduced psychotic disorders have recently been identified, and include female sex, temporal lobe involvement, and use of levetiracetam.3 We present a series of 3 patients who developed levetiracetam-induced psychosis and who met the aforementioned criteria. Our patients were 3 women with acquired brain damage secondary to cerebrovascular disease and presenting no history of psychiatric disorders. Mean age was 49 years (range, 32-63), and all 3 had recently been diagnosed with focal seizures (secondarily generalised) with structural causes9—11 in the context of vascular epilepsy.12 All 3 patients presented delusional ideation and disorganised thinking and speech within 10-14 days after starting treatment with levetiracetam 500-1000 mg/12 hours; 2 also reported visual hallucinations (patients 2 and 3).