Levetiracetam (Lecoverun) and Autism Spectrum Disorder
Levetiracetam is not recommended for the treatment of autism spectrum disorder, as there is no evidence supporting its use for core autism symptoms or associated behavioral features, and it is not FDA-approved for this indication.
Current Evidence-Based Pharmacotherapy for Autism
The only FDA-approved medications for symptoms associated with autism spectrum disorder are risperidone and aripiprazole, both approved specifically for treating irritability (including aggression, tantrums, and self-injurious behavior) in children and adolescents aged 5-16 years 1, 2, 3.
FDA-Approved Treatment Options
Risperidone is FDA-approved for irritability associated with autistic disorder in patients aged 5-16 years, with demonstrated efficacy in reducing physical aggression and severe tantrum behavior 1.
Aripiprazole is similarly FDA-approved for irritability in autism spectrum disorder 2, 4.
These medications target associated behavioral symptoms, not the core social communication deficits or restricted interests that define autism 2.
What Levetiracetam Actually Treats
Levetiracetam (brand name Keppra, not "Lecoverun") is an antiepileptic medication. While epilepsy is the medical condition most highly associated with autism 5, antiepileptic drugs have inconclusive efficacy for behavioral symptoms in autism 4.
Critical Distinction
The American Academy of Child and Adolescent Psychiatry recommends pharmacotherapy only when there is a specific target symptom or comorbid condition 6.
If a child with autism has comorbid epilepsy, levetiracetam may be appropriate for seizure management, but this does not address autism symptoms 6.
Evidence-Based Treatment Framework
First-Line Interventions
Behavioral interventions based on applied behavior analysis have the highest-quality data supporting effects on cognitive and language outcomes, with some programs requiring up to 40 hours per week 7.
Psychosocial therapies remain the only treatment options for core autism symptoms (social communication deficits and restricted behaviors) 2.
When to Consider Pharmacotherapy
The American Academy of Child and Adolescent Psychiatry recommends pharmacotherapy only for 6:
Specific target symptoms: aggression, self-injurious behavior, hyperactivity, inattention, compulsive-like behaviors, repetitive behaviors, sleep disturbances
Comorbid conditions: anxiety, depression, ADHD (present in approximately 75% of children with ASD) 7
Medication Options by Target Symptom
For irritability/aggression: Risperidone or aripiprazole (FDA-approved) 1, 2
For ADHD symptoms: Methylphenidate is effective; atomoxetine and alpha-2 agonists also appear effective 4
For repetitive behaviors: Selective serotonin reuptake inhibitors are NOT effective and frequently cause activating adverse events 4
Common Pitfalls to Avoid
Do not use medications unnecessarily due to possible side effects, particularly metabolic adverse events including weight gain and dyslipidemia with atypical antipsychotics 4, 3.
Children with autism are more susceptible to adverse medication effects; initiation with low doses and very slow titration is essential 2.
The American Academy of Child and Adolescent Psychiatry warns that some alternative treatments have been repeatedly shown not to work or lack supporting evidence, and clinicians should discuss risks and benefits with families 6.
Weight gain monitoring is critical: In pediatric trials of risperidone, mean weight gain was 2 kg in 3-8 weeks (versus 0.6 kg for placebo), with 33% gaining >7% body weight 1.
Combining medication with parent training is moderately more efficacious than medication alone for decreasing serious behavioral disturbance 6.