Side Effects of Levetiracetam (Antiepileptic Medication)
Levetiracetam's most common side effects include neurological symptoms such as somnolence, fatigue, dizziness, and behavioral changes including irritability, aggression, and mood disturbances.
Common Side Effects
Levetiracetam (commonly misspelled as "leuconamide") is an antiepileptic medication with several potential side effects that clinicians and patients should be aware of:
Neurological/Psychiatric Effects
- Somnolence/drowsiness
- Fatigue
- Dizziness
- Headache
- Behavioral disturbances:
- Irritability
- Aggression
- Depression
- Anxiety
- Mood changes
- Psychosis (rare)
Gastrointestinal Effects
- Nausea
- Vomiting
- Abdominal pain
- Loss of appetite
Other Common Side Effects
- Coordination difficulties
- Infection (particularly upper respiratory)
- Diplopia (double vision)
Monitoring and Management
When starting levetiracetam therapy, patients should be monitored for:
- Behavioral changes - These can occur rapidly and may require dose adjustment or medication discontinuation
- Neurological symptoms - Somnolence and dizziness often improve with continued use
- Hematological effects - Though rare, complete blood count monitoring may be warranted in some patients
Special Populations
Pregnancy Considerations
Levetiracetam is generally considered to have a more favorable profile in pregnancy compared to older antiepileptic drugs, but should still be used with caution and appropriate monitoring.
Elderly Patients
Dose adjustment may be necessary in elderly patients, particularly those with reduced renal function, as levetiracetam is primarily eliminated through the kidneys.
Pediatric Patients
Children may be more susceptible to behavioral side effects and should be closely monitored when starting therapy.
Risk Mitigation
To minimize side effects:
- Start with a low dose and titrate slowly
- Take with food if gastrointestinal side effects occur
- Monitor for behavioral changes, particularly during initial treatment and dose adjustments
- Consider evening dosing if daytime somnolence is problematic
Important Considerations
- Informing patients about potential side effects does not increase their likelihood of experiencing them 1
- Abrupt discontinuation may increase seizure risk; always taper gradually
- Side effects often diminish over time as tolerance develops
While levetiracetam has significant side effects, it generally has a more favorable side effect profile than many older antiepileptic medications, with less impact on hepatic function, fewer drug interactions, and minimal effects on cognitive function when compared to some alternatives.