{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:23:37Z","timestamp":1791559417475,"version":"4.3.4"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neuropsychopharm Rep"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sexual dysfunction is a common comorbidity in patients with epilepsy; it correlates with seizure frequency and right temporal lobe epilepsy and affects quality of life (QOL). Despite its clinical significance, sexual dysfunction is often underassessed in clinical practice. Brivaracetam (BRV), an anti\u2010seizure medication (ASM) introduced in recent years, is considered to have few psychiatric side effects, and no association with sexual dysfunction has been reported to date. We report a case of temporal lobe epilepsy in which the patient exhibited increased libido following the initiation of BRV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A woman in her 70s with drug\u2010resistant temporal lobe epilepsy, weekly focal seizures, and mild cognitive impairment was treated with brexpiprazole (BXP) for delusions of theft. BRV (50\u2009mg\/day) was initiated due to worsening epileptic seizures. Three weeks later, she developed persistent, intrusive sexual urges accompanied by self\u2010stimulatory behavior (e.g., genital touching). She initially concealed these symptoms due to embarrassment but disclosed them at the follow\u2010up 1\u2009month later. Given the temporal association with BRV initiation, the drug was discontinued, resulting in marked improvement within 2\u2009weeks and subsequent resolution. Throughout the course of treatment, no changes were observed in seizure frequency, cognitive function, or other ASMs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Previous reports have described increased libido with levetiracetam, which shares the same mechanism of action with BRV. Genetic factors, such as reduced striatal dopamine receptor density associated with DRD2\/ANKK1 polymorphisms may contribute to psychiatric side effects. In this case, BRV\u2010associated modulation of neurotransmission may have interacted with a vulnerable dopaminergic system, as indicated by the need for BXP. Preexisting bilateral hippocampal atrophy may also have provided a structural substrate resembling a pharmacologically induced incomplete Kl\u00fcver\u2013Bucy syndrome. Clinicians should be aware that patients may hesitate to report such symptoms and should actively monitor for changes in libido after initiating BRV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/npr2.70160","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T02:32:53Z","timestamp":1788229973000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Increased Libido Following Brivaracetam Initiation: A Case Report of Temporal Lobe Epilepsy"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8376-6700","authenticated-orcid":false,"given":"Toru","family":"Horinouchi","sequence":"first","affiliation":[{"name":"Department of Psychiatry Hokkaido University Graduate School of Medicine  Sapporo Hokkaido Japan"},{"name":"Department of Psychiatry and Neurology Hokkaido University Hospital  Sapporo Hokkaido Japan"},{"name":"Hokkaido University Epilepsy Center  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taiki","family":"Matsuyama","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Hokkaido University Graduate School of Medicine  Sapporo Hokkaido Japan"},{"name":"Department of Psychiatry Wakkanai City Hospital  Wakkanai Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayusa","family":"Mito","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Hokkaido University Graduate School of Medicine  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7936-0134","authenticated-orcid":false,"given":"Yuichi","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Hokkaido University Graduate School of Medicine  Sapporo Hokkaido Japan"},{"name":"Department of Psychiatry and Neurology Hokkaido University Hospital  Sapporo Hokkaido Japan"},{"name":"Hokkaido University Epilepsy Center  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5169-2930","authenticated-orcid":false,"given":"Takahiro A.","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Hokkaido University Graduate School of Medicine  Sapporo Hokkaido Japan"},{"name":"Department of Psychiatry and Neurology Hokkaido University Hospital  Sapporo Hokkaido Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2025.11.013"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2020.105697"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0006\u20103223(96)00411\u20108"},{"key":"e_1_2_12_5_1","first-page":"490","article-title":"Sexual Dysfunction in Patients With Epilepsy","volume":"33","author":"Tudor K. 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