What are the uses for Keppra (levetiracetam)?

From the Guidelines

Keppra (levetiracetam) is primarily used to treat various types of seizures, including partial-onset seizures, myoclonic seizures, and primary generalized tonic-clonic seizures, and is also used as an anticonvulsant prophylaxis in patients with newly diagnosed brain tumors or those receiving chimeric antigen receptor T cell therapy. The medication is available in oral tablet, extended-release tablet, and liquid solution forms, with dosages typically starting low and gradually increasing to an effective level based on patient response and tolerability. According to a study published in 2019 1, levetiracetam is recommended as an anticonvulsant prophylaxis in patients with newly diagnosed brain tumors or those receiving chimeric antigen receptor T cell therapy, with a dosage of 10 mg/kg, up to a maximum of 500 mg per dose, every 12 hours for 30 days following infusion.

Key Uses of Keppra

• Treatment of partial-onset seizures, myoclonic seizures, and primary generalized tonic-clonic seizures
• Anticonvulsant prophylaxis in patients with newly diagnosed brain tumors or those receiving chimeric antigen receptor T cell therapy
• Status epilepticus refractory to benzodiazepines, with a potential role as a treatment option, although definite proof awaits prospective randomized controlled trials 1

Administration and Dosage

• Oral tablet, extended-release tablet, and liquid solution forms
• Dosages typically starting low and gradually increasing to an effective level based on patient response and tolerability
• Common adult dosages range from 1000-3000 mg daily, divided into two doses
• For anticonvulsant prophylaxis in patients with newly diagnosed brain tumors or those receiving chimeric antigen receptor T cell therapy, a dosage of 10 mg/kg, up to a maximum of 500 mg per dose, every 12 hours for 30 days following infusion is recommended 1

Mechanism of Action and Side Effects

• Works differently from many other seizure medications by binding to a synaptic vesicle protein called SV2A in the brain, which helps regulate neurotransmitter release and reduces excessive neuronal firing that can lead to seizures
• Relatively few drug interactions, making it a good option for patients taking multiple medications
• Side effects may include drowsiness, weakness, dizziness, and in some cases, mood changes or behavioral problems, which should be reported to a healthcare provider if they occur.

From the FDA Drug Label

Levetiracetam is indicated as adjunctive treatment of partial onset seizures in adults and children 4 years of age and older with epilepsy. Levetiracetam is indicated as adjunctive therapy in the treatment of myoclonic seizures in adults and adolescents 12 years of age and older with juvenile myoclonic epilepsy Levetiracetam is indicated as adjunctive therapy in the treatment of primary generalized tonicoclonic seizures in adults and children 6 years of age and older with idiopathic generalized epilepsy.

The uses for Keppra (levetiracetam) are:

• Adjunctive treatment of partial onset seizures in adults and children 4 years of age and older with epilepsy.
• Adjunctive therapy in the treatment of myoclonic seizures in adults and adolescents 12 years of age and older with juvenile myoclonic epilepsy.
• Adjunctive therapy in the treatment of primary generalized tonicoclonic seizures in adults and children 6 years of age and older with idiopathic generalized epilepsy 2.

From the Research

Uses of Keppra (Levetiracetam)

Keppra, also known as levetiracetam, is an antiepileptic drug with various uses, including:

• Adjunctive treatment of partial-onset seizures with or without secondary generalization 3, 4, 5, 6
• Monotherapy treatment of partial-onset seizures with or without secondary generalization 3, 4, 5
• Adjunctive treatment of myoclonic seizures associated with juvenile myoclonic epilepsy 3, 4, 7, 5
• Adjunctive treatment of primary generalized tonic-clonic (GTC) seizures associated with idiopathic generalized epilepsy 3, 4, 7, 5

Mechanism of Action

The exact mechanism of action of levetiracetam is unknown, but it is believed to involve:

• Binding to synaptic vesicle protein 2A (SV2A) 3, 4, 5, 6
• Inhibiting calcium release from intraneuronal stores 3, 4
• Opposing the activity of negative modulators of GABA- and glycin-gated currents 3, 4
• Inhibiting excessive synchronized activity between neurons 3, 4
• Inhibiting N-type calcium channels 3, 4

Efficacy and Safety

Levetiracetam has been shown to be effective in reducing the frequency of seizures in patients with epilepsy 3, 4, 7, 5, 6. It is generally well-tolerated, with common adverse events including tiredness, behavioral abnormalities, and other mild to moderate effects 3, 4, 7, 5, 6.