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Electroencephalography was performed at baseline and those with active epileptiform discharges were excluded. Eligible participants were randomized to placebo for 12\u2009weeks or an active arm of oral levetiracetam (4\u2009weeks up\u2010titration to levetiracetam 500\u2009mg twice daily, 4\u2009weeks maintained on this dose followed by 4\u2009weeks down\u2010titration to nil). Participants then crossed over to the other arm. The primary outcome was change in cognitive function assessed by the Oxford Memory Task, a task sensitive to hippocampal memory binding. Secondary outcomes included tolerability, other neuropsychological scales, and general questionnaires.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Recruitment numbers were severely limited owing to restrictions from the COVID\u201019 pandemic at the time of the study. Eight participants completed both arms of the study (mean age 68.4\u2009years [SD\u2009=\u20099.2]; 5 females [62.5%]). No participants withdrew from the study and there was no significant difference between reported side effects in the active levetiracetam or placebo arm. Measures of mood and quality of life were also not significantly different between the two arms based on participant or carer reports. In limited data analysis, there was no statistically significant difference between participants in the active levetiracetam and placebo arm on the memory task.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>This pilot study demonstrates that levetiracetam was well tolerated in individuals with Alzheimer's disease who do not have a history of seizures and has no detrimental effect on mood or quality of life. Larger studies are needed to assess whether levetiracetam may have a positive effect on cognitive function in subsets of individuals with Alzheimer's disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>Abnormal electrical activity within the brain, such as is seen in seizures, might contribute to memory problems in people with dementia. We completed a clinical trial to see if an antiseizure medication, levetiracetam, could help with memory difficulties in people with Alzheimer's disease (the most common cause of dementia). In this pilot study, we could not prove whether levetiracetam helped memory function. We did show that the drug is safe and well tolerated in people with dementia who have not had a seizure. This work, therefore, offers a platform for future research exploring antiseizure medications in people with dementia.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.13070","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T12:39:49Z","timestamp":1728909589000},"page":"2353-2364","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Safety, tolerability, and efficacy outcomes of the Investigation of Levetiracetam in Alzheimer's disease (ILiAD)\u00a0study: a pilot, double\u2010blind placebo\u2010controlled crossover trial"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8948-4763","authenticated-orcid":false,"given":"Arjune","family":"Sen","sequence":"first","affiliation":[{"name":"Oxford Epilepsy Research Group, Nuffield Department of Clinical Neurosciences John Radcliffe Hospital  Oxford UK"},{"name":"Department of Neurology John Radcliffe Hospital  Oxford UK"},{"name":"Nuffield Department of Clinical Neuroscience University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1833-4995","authenticated-orcid":false,"given":"Sofia","family":"Toniolo","sequence":"additional","affiliation":[{"name":"Department of Neurology John Radcliffe Hospital  Oxford UK"},{"name":"Nuffield Department of Clinical Neuroscience University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin You","family":"Tai","sequence":"additional","affiliation":[{"name":"Oxford Epilepsy Research Group, Nuffield Department of Clinical Neurosciences John Radcliffe Hospital  Oxford UK"},{"name":"Department of Neurology John Radcliffe Hospital  Oxford UK"},{"name":"Nuffield Department of Clinical Neuroscience University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Akinola","sequence":"additional","affiliation":[{"name":"Local Clinical Trials Network John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mkael","family":"Symmonds","sequence":"additional","affiliation":[{"name":"Oxford Epilepsy Research Group, Nuffield Department of Clinical Neurosciences John Radcliffe Hospital  Oxford UK"},{"name":"Nuffield Department of Clinical Neuroscience University of Oxford  Oxford UK"},{"name":"Department of Clinical Neurophysiology John Radcliffe Hospital  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Mura","sequence":"additional","affiliation":[{"name":"Clinical Trials Pharmacy John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Galloway","sequence":"additional","affiliation":[{"name":"CPSU Oxford Health Foundation Trust  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Hallam","sequence":"additional","affiliation":[{"name":"St Mary's Pharmaceutical Unit Cardiff University  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane Y. 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