side effects, dosage, how to take & discontinue, uses, pros & cons, and more
Keppra Article Index | Brand and Generic Availability ›
Learn More about Taking and Discontinuing Keppra
Brand & Generic Names; Drug Class
Keppra’s Approved & Off-Label Uses (Indications)
US FDA Approved Treatment(s)
Extended-release (XR): as an add-on for partial onset seizures. Immediate-release (IR) & intravenous injection(IV): add-ons for partial & generalized seizures, and for JME.
Popular Off-Label Uses
Keppra is used to treat seizures caused by brain tumors. As a bonus it helps nuke those tumors and even deal with chemo side effects. See the page on off-label uses for details.
Keppra is also used off-label as monotherapy (by itself) for partial & generalized seizures and JME. Absence seizures, seizures and other damage caused by traumatic brain injury, Lennox-Gastaut syndrome, and various other forms of epilepsy and seizure disorders. Like most AEDs Keppra is used off-label to treat migraines, neuropathic pain, bipolar disorder, anxiety disorders, and substance abuse/addictions.
Learn More about Keppra’s Approved & Off-label Uses
How Long Until Keppra Starts Working (Onset of Action)
Not very. Like, as in two days not very. Even for refractory epilepsy Keppra can start working in one day.
Likelihood of Working
As an add-on for epilepsy, pretty good. About half the people who take it have their seizures reduced by at least 50%, and most of them keep taking it after three years.
Where Keppra really shines is for people with refractory (otherwise uncontrollable) epilepsy. The chances of working are almost as good: around 40% of people who take it have their seizures reduced by half, and some become seizure-free.
Learn how Keppra Compares with Other Drugs
How to Take Keppra
According to UCB you can start Keppra XR at 1000mg once a day and that’s it, sort of like Invega. They said the say thing about the immediate-release version as well, although with two 500mg doses. Although 500mg is the low-end of the therapeutic range. If you haven’t achieved symptom control, or you lose symptom control, your doctor may increase your dosage by 1000mg a day (taken once a day for KeppraXR and two 500mg doses for immediate-release Keppra) each week until you hit the maximum recommended dosage of 3000mg a day.
Guess what? I disagree.
UCB makes 250mg tablets for a reason, and Keppra immediate-release Keppra is really easy to split in half. So 500mg a day is probably a much better place to start. Hell, they don’t even make a 1000mg XR tablet!
And one week means seven days, not five.
Even though the XR is supposed to be once-a-day dosing and the IR twice-a-day, you may want to consider three-times-a-day (TID) dosing for IR and twice-a-day (BID), maybe even TID dosing to deal with any psychiatric side effects.
How to Stop Taking Keppra (Discontinue, Withdrawal)
Slowly, unless being on Keppra is sucking serious ass. And this is why I don’t like starting a med at a therapeutic dose. OK. End soapbox. Generally, the way you went up—was it in 250mg increments, 500mg increments? Please say it wasn’t in 1000mg increments. How you went up on Keppra is how you should go down from Keppra —500 to 250 every 5 to 7 days.
Keppra’s Pros and Cons
Low side effect profile. As in fewer side effects than the placebos in several of the clinical trials. Much less chance of your flipping out on it when compared to other anticonvulsants (E.g. Keppra: 10% of epileptics with previous histories of psychiatric or serious epileptic flippage had issues. Topamax: 24% of similar people had issues.) Tends to make people smarter, not dumber like most anticonvulsants. Even people starting with learning disabilities can get a bit of a boost. Also, unlike many anticonvulsants it’s so easy on your liver you can take it after a freaking liver transplant! It starts working right away, and many people can start at or near the therapeutic dose if required-it was designed that way. One researcher describes it as having, “close to ideal pharmacokinetic properties.”
A lot of the side effects it does have are psychiatric. Reports from the field (a.k.a. anecdotal evidence) suggest the most common are the deep, sometimes suicidal depression. Another favorite is the Keppra rage, although this one seems to be overhyped, and the XR version may have dealt with that for many people in any event. Far less frequent, but still reported, are hallucinations - one woman I know with epilepsy had deep philosophical conversations with a ghost every night. And there’s this case report of a kid getting a bit psychotic on Keppra. Those kind of suck-especially when no one bothers to warn you that they might happen.
Interesting Stuff your Doctor Probably didn’t Tell You about Keppra
Keppra doesn’t mess with, like, anything. In that it has practically no drug-drug interactions. That in and of itself is pretty interesting. Girls get more bang for their buck than boys with Keppra. Per the PI sheet women absorb 20% more of Keppra than men do. Keppra is by far the worst tasting pill on the market. Everyone who whines about how bad Lamictal tastes should lick a split Keppra. Then a split Topamax. Topamax’s taste warrants a mention in its PI sheet (although it turns out you’re not supposed to split Topamax because that hoses its rate of absorption, and isn’t really about the taste), and Keppra tastes even worse. All the other super interesting stuff is really geeky and belongs on other pages
Best Known for
Being the AED that will either fix you when nothing else can, or kill you because it’ll make you suicidally depressed and/or so enraged at the world that you’ll die because half-a-dozen cops had to tase you.
In-Depth Pros & Cons
Don’t worry about actually buying one. Windows shop and share the designs you’d like to buy. Do you have something better to do right now?
Keppra’s Potential Side Effects (Adverse Reactions)
Typical Side Effects
Like most AEDs: sleepiness, headache, and dizziness/vertigo. What most crazy meds have as uncommon-to-rare, but are common side effects for Keppra: Muscle weakness and various kinds of infections-rhinitis, pharyngitis, sinusitis, and assorted nose problems.
Uncommon Side Effects
The mood problems-depression, psychosis, hostility, anxiety in various forms (I know, it’s supposed to be good for anxiety. But yet…drugs are weird…). Appetite changes one way or another. Paresthesia, aka that fun tingling in your extremities like Topamax does.
Freaky Rare Side Effects
Peace-Love-and-Fluffy-Bunnies-Not-Manic-Just-Happy! OK, so Kassiane may have been the only one who got that for very long. Fungal infection. Gingivitis. The personal hygiene supply companies have a big market with people taking anticonvulsants.
Learn More about Keppra’s Side Effects.
TMI at times
What You Really Need to be Careful About
Keppra’s Black Box and Other Warnings, Pregnancy Category, etc.
Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream, so there’s nothing swimming around to attach itself to your brain and start doing stuff1. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what2, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood. If we’ve found the complete clearance, or how to calculate it if it requires things like your weight and what your piss looks like, you’ll find that on levetiracetam’s pharmacokinetics page.
How levetiracetam Works
the current best guess at any rate
You know how very few AEDs work the same way? Keppra is way more different than all of them. It binds to synaptic vesicle protein 2A (SVP2A) ligands (in English: reduces whatever the hell neurotransmitters or something else interacts with your brain via that stuff) and by doing so stabilizes any imbalance of the potassium and calcium voltage channels. This happens mostly in the hippocampus and amygdala, the latter of which explains the profound mood effects.
Learn More than You Probably Ever Wanted to Know about How levetiracetam Works
AKA mechanism/method of action, pharmacodynamics
Ratings, Reviews, Comments, PI Sheet, and More
Keppra, Keppra, how I love my Keppra. My favorite anticonvulsant ever, and I’ve been on quite a few. Not only was my refractory epilepsy controlled for the first time ever, but Keppra made me happy. Yes, you read that right. Happy. Maybe that’s the effect of dekindling. I don’t know. But I was really cheerful, and my general anxiety was really low-OCD was bad, like, pull off the keys off the keyboard bad, but I can live with that. I was sleeping. And I got back cognitive skills I lost in the car accident I was in back in March 2005 - complex things like adding and subtracting 2 digit numbers so I don’t need to ask the bank people do to it. Keppra is brain miracle in a little yellow pill.
It appears that, like many anticonvulsants, if what Keppra does is what you need, then you don’t get the cognitive side effects, only for this med those side effects are psychiatric not “me feel stupid.” Or that could be me talking out my ass again.
If Brain/Pain Doctor Of Choice is suggesting you try Keppra it’s worth a shot; especially if someone is around to make sure you don’t completely flip your shit. Based on everything on various support forums, it’s a med that either you love or you hate.
As if I didn’t go on long enough already.
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If you’re still feeling judgmental as well as just mental3, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.
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Pages and Forum Topics Google Thinks are Relevant to Your Mental Health
It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.
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- Keppra’s Full US Prescribing Information
- Faught, Edward. “Topiramate in the treatment of partial and generalized epilepsy.” Neuropsychiatric disease and treatment 3.6 (2007): 811-821.
Keppra Article Index | Brand and Generic Availability ›
1 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady stage if they can't get, or won't provide a number for that.
2 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.
3 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!
4 These include: Canada's Product Monographs (PM), New Zealand's Medicine Data Sheets (MDS), the EU's European Public Assessment Reports (EPAR), and the Summary of Product Characteristics (SPC) used in Britain, Ireland, and many other places.
If you have any questions not answered here, please see the Crazymeds Keppra discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.net)
|Last modified on Sunday, 20 July, 2014 at 15:24:40 by JerodPoore||Page Authors K A Sibley, Jerod Poore||Date created Tuesday, 04 October 2011 at 11:12:28|
|“Keppra (levetiracetam): a Review for the Educated Consumer” by K A Sibley is copyright © 2011 K A Sibley||Published online 2011/10/04|
Keppra, and all other drug names on this page and used throughout the site, are a trademark of someone else. Keppra’s PI Sheet will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.
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Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, and 2015 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
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Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList,
NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Crazymeds is optimized for ridiculously large screens and browsers that don’t block ads. I use Firefox and Chrome, running under Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
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‘Everything is true, nothing is permitted.’ - Jerod Poore
1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion as anonymity on teh Intergoogles. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.
* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.
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