Side Effects of Levetiracetam (Keppra) in a 2-Year-Old Girl
For a 2-year-old girl prescribed levetiracetam (Keppra) for 3 weeks, the most common side effects include somnolence, irritability, behavioral changes, and dizziness, while long-term effects are generally minimal when used short-term.
Common Short-Term Side Effects
Levetiracetam (Keppra) can cause several side effects in young children, with the most frequently reported ones being:
Neurological effects:
- Somnolence (drowsiness)
- Dizziness
- Fatigue
Behavioral effects:
- Irritability
- Hostility
- Nervousness
- Emotional lability (mood swings)
Other common effects:
- Decreased appetite
- Nasopharyngitis (common cold symptoms)
- Headache
According to FDA drug information, the most common adverse events in pediatric patients include somnolence, accidental injury, hostility, nervousness, and asthenia (weakness) 1.
Less Common Side Effects
Less frequently reported side effects include:
- Gastrointestinal issues (nausea, vomiting)
- Cough
- Rash
- Coordination difficulties (ataxia)
- Tremor
Behavioral Side Effects
Behavioral side effects deserve special attention as they are more common in pediatric patients:
- Irritability and moodiness
- Hyperactive behavior
- Hostility
- In rare cases, more severe behavioral changes 2
One study reported that behavioral side effects occurred in approximately 26.9% of pediatric patients, with severe behavioral effects (psychosis, confusion) in about 6.4% 3.
Long-Term Effects
For a 3-week course of treatment:
- Minimal long-term concerns: The short duration of therapy (3 weeks) significantly reduces the risk of long-term effects.
- Reversibility: Most side effects resolve completely after discontinuation of the medication.
The half-life of levetiracetam in children is approximately 5 hours 4, which means the drug will be eliminated from the body within a few days after stopping treatment.
Monitoring Recommendations
During the 3-week treatment period, parents should monitor for:
- Changes in behavior or mood
- Excessive drowsiness that interferes with daily activities
- Any signs of allergic reaction (rare)
- Changes in eating patterns
What to Expect After Discontinuation
After completing the 3-week course:
- Most side effects typically resolve within 24-72 hours
- No tapering is usually required for short-term therapy
- No long-term neurological or developmental effects have been documented from short-term use
When to Seek Medical Attention
Parents should contact their healthcare provider immediately if the child experiences:
- Severe behavioral changes
- Prolonged or severe drowsiness
- Any signs of allergic reaction
- Unusual movements or seizures
Bottom Line
For a 2-year-old taking levetiracetam for only 3 weeks, the risk of serious or long-lasting side effects is low. Most children tolerate the medication well, and any side effects that do occur typically resolve quickly after the medication is discontinued. The benefits of seizure control generally outweigh the risks of short-term side effects for most children.