Keppra - A Miracle Drug or A Nightmare?

 As most people know, there are a lot of different anti-seizure medications on the market. But they’re not all created equal; some are used to treat certain kinds of epilepsy, some are efficient, and some are even dangerous. Sorting through them all to find the right one for someone with epilepsy is no easy task.

But in most cases, it has to be done. And there are a few select medications that are chosen more often than others. One that you may have heard the name of at some point is Keppra. But the consensus over whether it’s a good or bad medication is still out for debate.

Some people swear by it, and insist that it’s changed their lives for the better. Other people have submitted troubling reports that it’s caused severe side effects and not even taken away their seizures in the process. 

But before we get into more of the reviews and what I personally think of Keppra, let’s get into the technicalities of it.

What Is Keppra?

Keppra is an anticonvulsant drug used to treat various types of epilepsy. It’s typically seen as an add-on therapy, working together with other seizure medications.  Levetiracetam is the generic form of Keppra that many use, but for the sake of this article I’ll just be referring to Keppra, although some of the information may apply to its generic form as it’s basically the same thing.

What is Keppra used to treat?

As I mentioned, Keppra treats a variety of seizures including: focal aware or simple partial seizure, focal impaired awareness or complex partial seizures, juvenile myoclonic epilepsy, myoclonic seizures, secondarily generalized seizures or bilateral tonic clonic seizures, temporal lobe epilepsy, and tonic-clonic seizures.

What is the recommended dosage of Keppra?

The dosage will depend on the needs of the patient as well as pre existing medical conditions. 

In older teens and adults it will normally start out at about 250-500 mg twice a day; and the target is to get the patient on 1,500 mg twice a day, so basically 3,000 mg per day.

And in children and infants, the dosage will depend on the size of the patient.

What forms is Keppra taken in?

Keppra comes in tablet form in dosages of 250 mg, 500 mg, 750 mg, and 1000 mg. There’s also a liquid solution that can be taken orally at 100 mg. And finally, there’s a liquid solution which can be injected at 100 mg.

What are the side effects of Keppra?

There’s a long list of possible side effects of Keppra, some being listed as common and others being seen as slightly more rare.

The common side effects are listed as follows…

• A loss of appetite
• Weakness
• Dizziness
• Drowsiness and/or tiredness
• Irritability and/or Aggression
• A stuffy nose
• And potential infection

In case of an allergic reaction you’re advised to keep an eye out for a red and purple skin rash that may result in blistering and peeling, hives, swelling in your face and/or throat, a sore throat, painful burning in your eyes, fever, and difficulty breathing.

Increased thoughts of suicide have also been reported by those taking Keppra; so you should contact your physician if you ever experience sudden or serious behavioral and mood changes such as agitation/aggression or bouts of sadness, increased depression or anxiety, and thoughts of harming yourself.

There are other side effects as well, but those are some of the main ones.

People who already suffer from depression or other types of mental illness, as well as those that have kidney disease or are on dialysis should discuss these facts with a physician before starting Keppra.

Keppra Rage -

This counts as a side effect, but because of its severity I think it’s deserving of its own section. There have been accounts of Keppra users suffering from severe bouts of aggression known as “Keppra rage”. 

People without any previous issues with anger management have been known to begin struggling with it after they begin this medication, sometimes to the point of becoming violent with loved ones. Keppra rage doesn’t affect everyone but it’s a real risk.

The Reviews -

As I prefaced, people generally love Keppra or hate it. It’s easily one of the most debated anti-seizure medications out there.

On one side are the people who it has helped, and there are quite a few of them. You see, Keppra is often prescribed to people who aren’t responding well to other medications. So for many, Keppra was their last hope to gain seizure control. Therefore those who found their seizure control are intensely grateful to the medicine.

It’s also worth noting that many anti-seizure medications are dangerous to take for women, because it can affect their reproductive health and cause possible birth defects in the baby. Keppra is one of the few drugs that you can potentially continue taking, even while being pregnant. 

So especially for females with epilepsy, Keppra can make a big difference.

But then, there’s the other side.

In contrast to all the beautiful stories of Keppra being just the thing someone needed, are stories that make many people reconsider their positive viewpoint. These are stories of people who have not only been unable to find seizure control on Keppra, but sometimes have actually been harmed by the medicine.

All the side effects I listed above have been reported, with varying severities. And in addition, some people find that they actually have an increase of seizures with Keppra. If you’re a numbers person, it’s estimated that almost half of Keppra users have negative effects from it.

So there you have it, the two extremes. Now I’d like to share my daughter’s experience with Keppra…

My Daughter’s Experience With Keppra -

The Backstory -

For those of you that don’t know, I have a daughter named Rach who has suffered from epilepsy since she was a toddler. She was diagnosed with juvenile myoclonic epilepsy, and most suffers from myoclonic jerks but has had a few tonic-clonics as well. 

Initially her neurologist prescribed Depakote and she was able to be seizure free for long enough that we were actually able to wean her off the medicine. She was seizure free for several years, but then they started to come back.

This time, she was prescribed Depakote again but it didn’t result in seizure freedom. She still had nocturnal seizures, and myoclonic jerks during the day. She was also having some side effects from the Depakote. We took her to an epilepsy specialist, and it was there that she was prescribed Keppra.

Our Experience -

Almost immediately after consulting with us, the new doctor decided he wanted to wean her off of Depakote while starting her on Keppra. He claimed that Keppra was the safer medication. The doctor’s office provided us with a schedule to do this, but after I took a closer look at it; it seemed like we would be weaning Rach off the Depakote too quickly.

I wanted to trust the doctor, so we started on the schedule. It didn’t take long until Rach’s myoclonic jerks began to cluster, and based on past experiences, I felt like a tonic-clonic was coming. I reached out to the doctor and it was confirmed that there had been a mistake in the schedule and we needed to wean her more slowly and add more Keppra.

At this point, the medicine can hardly be blamed and it was simply a matter of switching up the strategy. But then, even though we adjusted the schedule, Rach’s seizures still continued to get worse. And aside from that; she had no energy and was so nauseous that she could barely eat.

After I called the doctor again, they agreed to put her back on Depakote but keep the 3000 mg dose of Keppra as well. I asked if they thought the Keppra was making her worse, but they said that couldn’t be the case. 

Around the one month mark of starting Keppra, she had gone from 30/40 myoclonic seizures the month before to 300 daytime seizures the first month on the Keppra. Also around the one month mark; Rach started to get depressed and began getting very angry very quickly.

After noticing these new symptoms I tried to contact the doctor but couldn’t reach them. I began to lower the dose myself, and when the doctor finally did call back; I was told she had to stay on at least 2000 mg of Keppra.

But even that small lowering of the dose helped, so the doctor ended up giving me the go ahead to wean Rach off the Keppra completely. It took a few months being Keppra free, but Rach eventually started to feel more like herself. And almost six months after we started her on Keppra, she finally had a seizure free day again.

It’s safe to say that my daughter and I didn’t have the best experience with Keppra; she experienced a lot of the negative effects and none of the good ones. So now let’s get to my final thoughts.

Conclusion -

I believe that everything comes with downsides, and I know that something as powerful as an anti-seizure medication is no different. For instance, although Depakote has helped Rach control her seizures; it has resulted in some side effects. And I know that for some people, Depakote has been equally as damaging to them as Keppra was to Rach.

So it’s not up to me or any one person to decide whether or not Keppra is good or bad for anyone, I think it’s situational. For some people, it might be just the thing you need. But for others, it might have more negatives than positives.

I just wanted to write this post to inform other people who are thinking about adding Keppra to their treatment; don’t go into it blindly. I’m a big believer in doing research before taking any important medical step if you have the time, so I know I would’ve loved more honest resources regarding Keppra when we were making the transition.

And I hope that this post has served as a resource for someone out there. I’ll cite my sources at the bottom of this page if you’d like more reading material. And if you have any thoughts to add to the Keppra conversation then I’d love to hear your comments. Thank you for reading!

Sources -

Epilepsy Talk's Article On Keppra

Drugs.com Profile On Keppra