What are the effects of cannabis use with Keppra (levetiracetam)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 27, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

I strongly advise against using cannabis while taking Keppra (levetiracetam) without consulting your healthcare provider first, as the combination may potentially increase side effects such as dizziness, drowsiness, and impaired coordination or thinking. Keppra is an antiepileptic medication that works by stabilizing electrical activity in the brain, while cannabis contains compounds that can affect brain function in ways that might interfere with seizure control 1. Some patients report that cannabis helps their seizures, while others experience worsened seizure control.

Key Considerations

  • The interaction between cannabis and Keppra varies between individuals based on factors like the type of cannabis product, THC/CBD content, frequency of use, and personal medical history 1.
  • Cannabis use can increase the risk of motor vehicle accidents, with drivers who test positive for cannabis being more than twice as likely to be involved in motor vehicle crashes 1.
  • Common side effects of cannabis include feeling sleepy, dizzy, confused, and having a dry mouth, with more serious risks including a racing heartbeat and breaks with reality (paranoia or psychosis) 1.
  • Older adults may be at higher risk of confusion and falls when using cannabis than younger people 1.

Recommendations

  • If you're considering using cannabis while on Keppra, speak with your neurologist about your specific situation, as they may need to monitor you more closely or adjust your medication dosage 1.
  • Never stop taking Keppra suddenly as this can trigger seizures.
  • Your healthcare provider can help determine if the combination of cannabis and Keppra is safe for your particular circumstances, taking into account your individual needs and medical history 1.

From the Research

Cannabis Use with Keppra

  • Keppra, also known as levetiracetam, is an antiepileptic drug (AED) used to treat various seizure disorders 2.
  • There is evidence to suggest that cannabidiol (CBD), a non-psychoactive compound found in cannabis, may interact with Keppra and other AEDs 3, 4.
  • Studies have shown that CBD can enhance the anticonvulsant activity of Keppra and other AEDs, but may also increase the risk of adverse effects such as somnolence, decreased appetite, and diarrhea 3, 5.
  • The interaction between CBD and Keppra is thought to occur through both pharmacokinetic and pharmacodynamic mechanisms, including the alteration of brain concentrations of AEDs and the modulation of ionic channels and neurotransmitter transporters 4.
  • Clinical trials have demonstrated the efficacy and safety of CBD as an adjunctive treatment for patients with epilepsy, including those with Lennox-Gastaut syndrome and Dravet syndrome 6, 5.
  • However, the use of CBD with Keppra and other AEDs requires close monitoring for potential interactions and adverse effects, particularly in patients with a history of psychiatric and neurobehavioral problems 2, 4.

Key Findings

  • CBD can interact with Keppra and other AEDs, increasing the risk of adverse effects 3, 4, 5.
  • The combination of CBD and Keppra may be effective in reducing seizure frequency in patients with epilepsy 3, 5.
  • Close monitoring is necessary to minimize the risk of adverse effects and optimize the therapeutic benefits of CBD and Keppra 2, 4.
  • Further research is needed to fully understand the interactions between CBD and Keppra, as well as the potential benefits and risks of using these substances together 3, 4, 6, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Levetiracetam for managing neurologic and psychiatric disorders.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 2009

Research

Drug-drug interactions between antiepileptics and cannabinoids.

Expert opinion on drug metabolism & toxicology, 2019

Research

Cannabis and Epilepsy.

Journal of dual diagnosis, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.