Neuropsychiatric adverse events of antiepileptic drugs in brain tumour‐related epilepsy: an Italian multicentre prospective observational study

Background and purpose We assessed the prevalence and magnitude of neuropsychiatric adverse events ( NPAE s) associated with antiepileptic drugs ( AED s) among patients with brain tumour‐related epilepsy ( BTRE ). Methods This observational, prospective, multicentre study enrolled 259 patients with BTRE after neurosurgery. All patients received AED monotherapy. Efficacy was assessed through clinical diaries, whereas NPAE s were collected using the Neuropsychiatric Inventory Test‐12 questionnaire at baseline and after 5 months. Results Tumour localization in the frontal lobe was associated with a higher prevalence of NPAE s (odds ratio, 7.73; P < 0.001). Independent of tumour localization, levetiracetam ( LVT) treatment was associated with higher prevalence and magnitude of NPAE s (odds ratio, 7.94; P < 0.01) compared with other AED s. Patients with oligodendroglioma reported more NPAE s than patients with other tumour types. NPAE s were not influenced by chemotherapy, radiotherapy or steroid treatment. Evaluating non‐neurobehavioural adverse events of AED s, no significant differences were found among AED s, although patients treated with old AED s had a higher prevalence of adverse events than those treated with new AED s. Conclusions Both tumour localization in the frontal lobe and LVT treatment are associated with a higher risk of NPAE s in patients with BTRE . LVT is regarded as a first‐line option in patients with BTRE because of easy titration and few significant drug‐to‐drug interactions. Thus, as NPAE s lead to poor compliance and a high dropout rate, clinicians need to accurately monitor NPAE s after AED prescription, especially in patients with frontal lobe tumours receiving LVT .