[dampex]

Hi, I'm an Italian Psychiatrist interested in cognitive impairment, delirium and dementia. I'm treating an old patient (79 yrs) with organic and vascular dementia, ansious state, aggressiveness, and walking deficits. I've started a therapy with levetiracetam (Keppra), because patient's family doesn't find a way to manage his behaviour, but something is going bad...
At 500-750 mg dose, the drug is apparently ineffective, but at 1000 mg/die the patient shows a pronounced confusional state, though aggressiveness vanishes. This effect isn't due to interaction with other drugs. Is there something that has experienced this collateral effect with his patients? I need help to best manage clinical trend... I'm thinking to switch to gabapentin or valproic acid, but I'm not sure this is the right thing to do (especially because I have only a little amount of time before discharge).
Thank you all,
damiano