Can Keppra (levetiracetam) cause dizziness?

Dizziness as a Side Effect of Keppra (Levetiracetam)

Yes, Keppra (levetiracetam) commonly causes dizziness as a side effect, affecting approximately 9% of adult patients taking the medication compared to 4% in placebo groups. 1

Evidence for Dizziness as a Side Effect

The FDA drug label for levetiracetam clearly identifies dizziness as one of the most common adverse effects:

• In adults with partial onset seizures, dizziness occurs in 9% of levetiracetam-treated patients versus 4% of placebo-treated patients 1
• In pediatric patients, dizziness occurs in 7% of levetiracetam-treated patients versus 2% of placebo-treated patients 1
• Vertigo (a specific type of dizziness) is reported in 3% of levetiracetam-treated adults versus 1% of placebo-treated patients 1

Timing and Characteristics

The dizziness associated with Keppra:

• Typically appears during the first 4 weeks of treatment 1
• Is usually mild to moderate in intensity 1
• May be more pronounced when starting therapy or increasing dosage 2

Risk Factors and Management

Certain factors may increase the risk of experiencing dizziness with Keppra:

• Elderly patients may have greater sensitivity to this side effect 3
• Patients with renal impairment may require dose adjustment to prevent increased drug levels that could worsen dizziness 2
• Concurrent use of other medications that cause dizziness may compound this effect

Management strategies include:

1. Dose adjustment: Consider lower starting doses with gradual titration
2. Timing of administration: Taking the medication at bedtime may help reduce daytime dizziness
3. Patient education: Advise patients about this potential side effect and precautions
4. Safety precautions: Patients should be advised not to drive or operate machinery until they know how the medication affects them 1

Other Common Side Effects of Keppra

Dizziness is one of several common side effects associated with Keppra:

• Somnolence (15% vs 8% placebo) 1
• Asthenia (fatigue) 1
• Behavioral effects (irritability, agitation) in 12-15% of patients 4
• Headache 1

Clinical Implications

The presence of dizziness may impact:

• Patient adherence to medication
• Quality of life
• Risk of falls, particularly in elderly patients
• Ability to perform daily activities including driving

Conclusion

Dizziness is a well-documented side effect of Keppra that occurs in approximately 9% of adult patients. While usually mild to moderate and often transient, it should be discussed with patients prior to initiating therapy. For patients experiencing significant dizziness, dose adjustment, timing modification, or consideration of alternative antiepileptic medications may be warranted.