Can you stop Keppra (levetiracetam) abruptly?

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From the FDA Drug Label

Antiepileptic drugs, including levetiracetam, should be withdrawn gradually to minimize the potential of increased seizure frequency.

You should not stop Keppra (levetiracetam) abruptly. Gradual withdrawal is recommended to minimize the potential of increased seizure frequency 1.

From the Research

No, you should not stop Keppra (levetiracetam) abruptly. Discontinuation of Keppra should always be done gradually under medical supervision, typically over a period of at least 2-4 weeks with dose reductions of about 500 mg every few days. Stopping this anti-seizure medication suddenly can trigger withdrawal seizures, even in people who have been seizure-free while on the medication. This risk exists because your brain becomes accustomed to the medication's effects on neurotransmitters and neural activity. When the drug is suddenly removed, this can create an imbalance that may lower your seizure threshold.

If you need to discontinue Keppra for any reason, contact your healthcare provider immediately to create a safe tapering schedule. Even if you're experiencing side effects from the medication, continuing to take it until you have medical guidance is safer than stopping on your own. Your doctor may also need to substitute another anti-seizure medication during the tapering process to maintain seizure control. According to the most recent and highest quality study, 2, the long-term risk of seizure recurrence is possibly higher among adults who have been seizure-free for 2 years and taper antiseizure medications.

Some key points to consider when stopping Keppra include:

  • The risk of seizure recurrence is higher in certain patients, such as those with a history of smoking, longer duration of epilepsy, and frequency of seizures before control 3
  • A discontinuation program should include tailored discussion with patients and family members and individualized decision, the taper schedule, and plans for monitoring during and after drug tapering 4
  • The rate of seizure recurrence with ASM withdrawal following epilepsy surgery after 1 year of seizure freedom vs after 4 years is not significantly different than maintaining patients on ASMs 2

It's essential to prioritize your health and safety by following a gradual tapering schedule under medical supervision to minimize the risk of withdrawal seizures and ensure a smooth transition.

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.

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