ORCID
- Lance Watkins: 0000-0002-0447-5906
- Rohit Shankar: 0000-0002-1183-6933
Abstract
Purpose: One in five people with autism spectrum disorder have epilepsy and take Anti-Seizure Medications (ASM). However, the impact of ASM on people with autism is under researched. This study evaluates the efficacy and tolerability of Levetiracetam (LEV) for autistic people and epilepsy. Method: Data was derived from the English Epilepsy Research Database Register which compares ASM responses in those with neurodevelopmental disorders to those without. Age range was 18–50 years as there were no autistic research participants with autism prescribed LEV over 50. Twelve-month ASM data, including withdrawal rate, seizure frequency and adverse effects were compared. Fisher's exact test was used to assess univariate associations between outcomes and autism with significance accepted as p < 0.05. Logistic regression was used to assess autism group differences after adjustment for potential confounders (age, gender, presence of baseline physical and mental health conditions). Results: Of 175 (aged 18–50) research participants across 18 NHS Trusts, prescribed LEV between 2000 and 2020, 40 were autistic. There was no significant association between withdrawal rate (P = 0.626), or grouped side effects (physical P = 0.165, mental health P = 0.791). Autism was significantly associated with aggression with LEV in univariable analysis but this association was no longer significant after accounting for multiple testing A significant non-linear relationship between efficacy and the autism group (P < 0.001) was found. Conclusions: This study supports the use of LEV for people with autism and epilepsy as there is no difference in response noted to those without autism. However, they may have less prominent changes in efficacy.
DOI Link
Publication Date
2025-11-01
Publication Title
Epilepsy and Behavior
Volume
172
ISSN
1525-5050
Acceptance Date
2025-08-23
Deposit Date
2025-08-28
Funding
Data Collection Centres were supported by the UK National Institute of Health (NIHR portfolio 31484). This work was funded by the UK Charity Autistica (Grant ID: 7624) with recruitment and data collection at Data Collection Centres supported by the National Institute of Health (NIHR portfolio 31484).
Additional Links
Keywords
Anti-seizure medication, Autism spectrum disorder, Epilepsy, Levetiracetam, Research database
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Allard, J., Henley, W., McLean, B., Watkins, L., Parrett, M., Rajakulendran, S., Maguire, M., Ellawela, S., Tittensor, P., Bransgrove, J., Sen, A., Mohanraj, R., Bagary, M., Ram, S., Pashley, S., & Shankar, R. (2025) 'Levetiracetam in epilepsy and autism spectrum disorder: analysis of safety, tolerability, and efficacy', Epilepsy and Behavior, 172. Available at: 10.1016/j.yebeh.2025.110678
