From the Guidelines
Keppra (levetiracetam) is an antiepileptic medication with common side effects including drowsiness, dizziness, weakness, and behavioral changes such as irritability, aggression, and mood swings. The most recent and highest quality study on levetiracetam, 1, suggests that the medication is effective in treating seizures with minimal side effects.
Side Effects
Some common side effects of Keppra include:
- Drowsiness
- Dizziness
- Weakness
- Behavioral changes such as irritability, aggression, and mood swings
- Transient irritability, imbalance, tiredness, or lightheadedness, as reported in 11% of patients in the study by Koubeissi et al 1
Dosage Recommendations
For adults with epilepsy, the typical starting dose is 500 mg twice daily, which may be increased by 1000 mg/day every two weeks to a maximum of 3000 mg/day, as suggested by the study by Wheless et al 1. Children's dosing is weight-based, starting at 10 mg/kg twice daily with potential increases to 30 mg/kg twice daily. Dosage adjustments are necessary for patients with kidney impairment. Keppra should be taken consistently at the same times each day, with or without food, and should never be stopped abruptly as this can trigger seizures. The medication works by binding to synaptic vesicle protein SV2A in the brain, modulating neurotransmitter release and stabilizing electrical activity. Patients should monitor for serious side effects like severe mood changes, unusual bruising/bleeding, or allergic reactions, and report these to their healthcare provider immediately. It is essential to note that the studies by Ruegg et al 1, Fattouch et al 1, and Uges et al 1 provide valuable information on the efficacy and safety of levetiracetam in treating status epilepticus, but the study by Koubeissi et al 1 provides more relevant information on the side effects and dosage recommendations for Keppra.
From the FDA Drug Label
Adverse events were usually mild to moderate in intensity (%) (Adverse Events Occurred In At Least 1% Of Levetiracetam- Treated Patients And Occurred More Frequently Than Placebo-Treated Patients)
Nervous System Somnolence15%, Dizziness9%, Depression4%, Nervousness4%, Ataxia3%, Vertigo3%, Amnesia2%, Anxiety2%, Hostility2%, Paresthesia2%, Emotional Lability2%
Respiratory System Pharyngitis6%, Rhinitis4%, Cough Increased2%, Sinusitis2%
Special Senses Diplopia2%
The side effects of Keppra (levetiracetam) include:
- Nervous System: somnolence, dizziness, depression, nervousness, ataxia, vertigo, amnesia, anxiety, hostility, paresthesia, emotional lability
- Respiratory System: pharyngitis, rhinitis, cough increased, sinusitis
- Special Senses: diplopia The dosage recommendations are not explicitly stated in the provided text, but the side effects are listed for different patient populations, including adults and children with various types of seizures 2.
From the Research
Side Effects of Keppra (Levetiracetam)
- Common side effects of Keppra include [ 3, 4 ]:
- Fatigue
- Headache
- Dizziness
- Nausea
- Vomiting
- Less common side effects include [ 5 ]:
- Changes in behavior or mood
- Sleep disturbances
- Increased risk of infections
- Rare but serious side effects include [ 6 ]:
- Increased risk of mortality due to heart failure
- All-cause mortality
Dosage Recommendations for Keppra (Levetiracetam)
- The effective terminal dose of levetiracetam is 1000mg [ 4 ]
- Dosage may vary depending on the patient's age, weight, and medical condition [ 5 ]
- Levetiracetam can be used as a monotherapy or in combination with other antiepileptic drugs [ 3, 4 ]