Levetiracetam (Keppra) and Sertraline (Zoloft) Can Be Safely Taken Together
Yes, levetiracetam (Keppra) and sertraline (Zoloft) can generally be taken together safely as there are no significant drug interactions between these medications. While all medication combinations should be monitored, this particular combination does not have known major interactions that would prevent concurrent use.
Drug Information and Compatibility
- Levetiracetam (Keppra) is an anticonvulsant used to treat various types of seizures and has a favorable drug interaction profile compared to many other antiepileptic medications 1
- Sertraline (Zoloft) is a selective serotonin reuptake inhibitor (SSRI) commonly used to treat depression, anxiety disorders, and other psychiatric conditions 1
- Unlike some other antiepileptic drugs, levetiracetam is not listed among medications that have significant interactions with SSRIs like sertraline 1
- Levetiracetam is specifically noted to be "weight neutral" in medication tables, meaning it doesn't typically cause weight changes when used, which can be an important consideration when combining with psychiatric medications 1
Pharmacological Considerations
- Levetiracetam has minimal effects on the cytochrome P450 enzyme system, resulting in fewer drug-drug interactions compared to many other antiepileptic medications 1
- Sertraline has some potential to interact with drugs metabolized by CYP2D6, but levetiracetam is not significantly affected by this pathway 1
- When considering antiepileptic medications, levetiracetam has fewer documented interactions with other medications compared to older agents like carbamazepine, phenytoin, or valproate 1
Safety Monitoring
- While these medications can be taken together, patients should be monitored for:
- Potential neurological side effects like dizziness, somnolence, or fatigue, which can occur with either medication and might be additive 1
- Mood changes or behavioral effects, as both medications can affect mood (levetiracetam occasionally causes irritability, while sertraline treats mood disorders) 1, 2
- Any signs of serotonin syndrome, though this is unlikely with this specific combination since levetiracetam does not significantly affect serotonin levels 1
Important Precautions
- Unlike some drug combinations, there is no evidence that levetiracetam and sertraline together increase the risk of seizures 1
- This combination does not require special dosing adjustments solely because they are being used together 1
- Neither medication requires therapeutic drug monitoring when used in combination 1
- Unlike some other antiepileptic drugs that can interact with SSRIs and potentially cause serotonin syndrome (especially when combined with MAOIs), levetiracetam does not carry this specific warning 1
Clinical Context
- Both medications are commonly prescribed for their respective indications, and their concurrent use may be necessary in patients with both epilepsy and depression/anxiety 2
- Some patients with treatment-resistant depression may benefit from combination antidepressant therapy, but the combination of sertraline with bupropion (rather than with levetiracetam) has been specifically studied for this purpose 3
- Levetiracetam has occasionally been investigated for psychiatric uses beyond epilepsy, which might explain why some patients are prescribed both medications 2
In summary, based on available evidence, levetiracetam (Keppra) and sertraline (Zoloft) can be safely taken together without major concerns about drug interactions. This combination does not appear on lists of problematic drug combinations in current clinical guidelines.