Models of Josephson et al for Predicting Psychiatric Adverse Effects Associated with Levetiracetam Therapy: Model Without Pre-Existing Mental Health Disorder
Levetiracetam is an antiepileptic medication that can cause psychiatric adverse effects. Josephson et al reported two models for identifying a patient at risk. The authors are from the University of Calgary and Icahn School of Medicine.
Patient selection: Levetiracetam therapy with no history of mental health problem
Outcome: adverse psychiatric effect within 2 years of starting therapy
Parameters:
(1) sex
(2) age
(3) levetiracetam daily dose in mg
(4) history of recreational drug use
Parameter
Finding
Points
sex
male
0
female
0.89
age
0.013 * (age)
daily dose
0.0003 * (dose)
history of recreational drug use
no
0
yes
1.16
value of X =
= SUM(points for all 4 parameters) - 3.83
probability of a psychiatric adverse effect =
= 1 / (1 + EXP((-1) * X))
An additional risk factor was low socioeconomic status.
Performance:
• The area under the ROC curve is 0.72.
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