Introduction: Body dysmorphic disorder (BDD) is an often severe disorder, but few treatment studies have been conducted. Objective: This pilot study explored the efficacy and safety of the antiepileptic medication levetiracetam for BDD. Methods: Seventeen subjects with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition BDD participated in a 12-week open-label levetiracetam trial. Subjects were assessed at regular intervals with standard measures. Results: In intent-to-treat analyses, scores on the Yale-Brown Obsessive Compulsive Scale Modified for BDD (BDD-YBOCS), the primary outcome measure, decreased from 32.5 +/- 4.7 at baseline to 21.5 +/- 11.0 at endpoint (P<.001). Approximately 60% (n=9) of subjects were responders (>= 30% decrease on the BDD-YBOCS). The mean time to response was 4.6 +/- 2.8 (range: 2-10) weeks. Scores also significantly improved on the Brown Assessment of Beliefs Scale, the Hamilton Rating Scale for Depression, the Global Assessment of Functioning Scale, and the Social and Occupational Functioning Assessment Scale. Scores did not significantly improve on the Quality of Life Enjoyment and Satisfaction Questionnaire, the Beck Anxiety Inventory, or the Social Phobia Inventory. The mean endpoint dose of levetiracetam was 2,044.1 +/- 1,065.2 (range: 250-3,000) mg/day, and it was relatively well-tolerated. Conclusion: Randomized, double-blind placebo-controlled studies of levetiracetam for BDD are needed to confirm these preliminary findings. CNS Spear. 2009;14(5):252-260
