The anticonvulsant levetiracetam potentiates alcohol consumption in non-treatment seeking alcohol abusers.

BACKGROUND: Levetiracetam (Keppra) is a commonly prescribed anticonvulsant that has been shown to attenuate alcohol consumption in an open-label study of treatment-seeking, alcohol-dependent subjects.

METHODS: Here we performed a 42-day placebo-controlled, double-blind, randomized crossover trial to evaluate the effects of levetiracetam on moderate to heavy drinkers receiving either a low (500-1000 g/d) or a moderate (1000-2000 g/d) dose. Electronic diaries were used to monitor daily ethanol intake.

RESULTS: Across the entire group, there was no effect of levetiracetam on drinking irrespective of dose, treatment order, family history, ethnicity, sex, or adverse effects. However, a median split of the data based on the number of drinks consumed while taking placebo revealed that levetiracetam significantly increased drinking in the lower drinking subjects (n = 23, P = 0.05, t = 2.07) while having no effect on drinking in the higher half (n = 23, P = 0.75, t = 0.32). Preliminary stratification based on common polymorphisms associated with alcoholism and impulsivity indicated that subjects with alcoholism-associated alleles may drink even more while taking levetiracetam.

CONCLUSIONS: Our data suggest that levetiracetam is not an appropriate treatment for non-treatment seeking alcohol abusers and can, in fact, increase their consumption of alcohol.