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Keppra Drug Guide: Effects, Abuse Potential, & Treatment

Epilepsy has no cure, but it can be treated, thanks to therapies and medication like levetiracetam — better known by its brand name Keppra.

This medication can be used by patients who are at least 4 years old who have a variety of seizures.

Keppra Use

Keppra can be a part of a multistrategy treatment for epilepsy, or it can be used on its own once patients are at least 16 years old.

The medication is sold as an oral tablet, but there is a liquid version that can be administered via intravenous therapy (IV) for patients who cannot take the oral version.

Keppra has also been studied as a possible treatment for alcohol use disorders.

MedlinePlus says Keppra works as an anticonvulsant.

It is possible to overdose on Keppra. Though extensive misuse has not been studied, some patients have self-reported that it can cause them to feel high.

To get an idea of why patients misuse the drug, it is important to know a little bit about epilepsy and seizures.

Understanding Epilepsy

Keppra is approved to treat epilepsy. The Mayo Clinic describes this health condition as a neurological disorder in which the brain experiences a very high activity level. Unusually high brain activity could cause a person to stare into space, have a seizure, or display different behavior.

Seizures are categorized into two groups.

  • Focal: seizures that mainly affect one part of the brain
  • Generalized: seizures that affect the entire brain

To receive a diagnosis for epilepsy, you must have had two seizures that happened without provocation. Once the diagnosis is found, patients may be able to treat it with surgery, while others may have to take medication for a long time or even for the rest of their lives. 

Using medication such as Keppra is often more advantageous than using nothing at all.

How Keppra Works

keppra pills

Tablet forms of Keppra should be swallowed whole and not chewed or crushed, according to MedlinePlus.

A liquid solution of Keppra is also available, and patients can use droppers or syringes to make sure they take the correct amount.

Taking this medication can cause you to feel different, and it may even cause moodiness or differences in normal behavior. On the other hand, you may also feel extremely well. In any case, patients should not stop taking Keppra suddenly.

Keppra is known to make patients feel drowsy, and you should not drive or operate heavy machinery once you’ve started taking it.

Studies have not looked at possible addiction or misuse of Keppra, but a 2013 study published on Seizure examined tolerance and saw that using Keppra constantly can cause it to be less effective. 

Keppra Statistics: Understanding Misuse

Tolerance is one way people can become more amenable to misusing a substance. When this happens, your body gets used to a given dose of a drug, so it stops working effectively. You may have to start taking more of it to feel the same effects.

The National Institute on Drug Abuse also states that prescription medication abuse is common. Abuse of stimulants, opioids, and depressants changes the brain and can trigger misuse. Keppra is known as an anticonvulsant because it can decrease activity in the brain.

A 2018 study published on Epilepsy & Behavior explains that Keppra can be used in recreational doses when taken in amounts of 4,000 mg (milligrams) or more. Of particular concern is that Keppra can actually cause patients to become suicidal as they first adjust to their dosage.

Long-Term and Short-Term Effects

Be careful when you start taking Keppra because it causes drowsiness at first. In the short term, people could experience:

  • Increasing suicidal ideation or thoughts of self-harm
  • Changes in behavior, such as giving things away or an abnormally cheery mood (mania)

Long-term studies show that Keppra may decrease in effectiveness. It is normal for doctors to revise your dose as you continue your treatment.

These side effects may occur as you adjust to your dose:

  • Reduced motor control
  • Double vision
  • Vomiting
  • Diarrhea
  • Decreased appetite
  • Loss of appetite
  • Drowsiness

The reported lethargy you might feel after Keppra is normal as you become more tolerant of it. In most people, building a tolerance to Keppra does not lead to misuse, but it can. 

Different From Other Prescription Drugs of Abuse

Keppra requires you to adjust to it so that it can be effective. This means tolerance is built into the process of taking it, making it unique among prescription drugs that are often abused.

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When a person takes prescription medication, such as opioids or even an illicit drug, a change in mood is often seen as a negative symptom. The National Institute on Drug Abuse (NIDA) mentions that if a person uses a drug despite its negative impact, this is a sign of addiction.

With Keppra, discontinuing use is what might cause additional problems. Understanding whether or not it causes withdrawal is also an issue because suicidal thoughts and ideas of self-harm are often expected when a person stops using Keppra.

On June 2012, the Journal of Analytical Toxicology published a study that looked at coroner reports involving levetiracetam found after death. The report looked at reports from North Carolina and found that 56 deaths could be linked with the medication since 2003.

Additional findings from the report were:

  • Suicide is common in epilepsy patients who have taken levetiracetam.
  • Levetiracetam may be more dangerous than previously thought.
  • Taking too much of the medication often caused respiratory issues, and getting support on time helped patients who had overdosed.

Unlike other prescription or over-the-counter medications that are commonly abused, the symptoms of Keppra misuse show up differently. Patients have self-reported common side effects on forums such as Reddit.

  • Keppra makes most people feel drunk and/or lethargic for at least a week.
  • One commenter mentioned feeling this way during the first few dose increases.
  • Changes in mood, especially in temper, are common.

The U.S. Food and Drug Administration also warns that you cannot just stop taking Keppra unless you talk to your doctor. The FDA does not mention withdrawal, but quitting Keppra cold turkey could make seizures come back.

What We Know So Far

Keppra is different from other drugs of abuse in that its risk of suicidal thoughts or actions of self-harm may have something to do with overdose rates and even fatalities.

Building a tolerance to, and even dependence on, Keppra is part of what allows it to treat seizures so effectively, but that does not mean it will cure epilepsy or seizures.

Feeling erratic changes in moods, including thoughts of self-harm, is a known side effect. A rise in temper is also a common issue.

If you have been taking Keppra for a long time and worry that you have built up too much tolerance to it or have been feeling good for a while, you should discuss suspension of use with a doctor who can provide you with options based on your current health status. 

Sources

(June 2013) Levetiracetam Has Opposite Effects on Alcohol- and Cocaine-Related Behaviors in C57BL/6J Mice. Neuropsychopharmacology. Retrieved March 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3656375/

(April 2013) Loss of the initial efficacy of levetiracetam in patients with refractory epilepsy. Seizure. Retrieved March 2019 from https://www.sciencedirect.com/science/article/pii/S1059131112003238

(March 2019) Brand Name: Keppra. Healthline. Retrieved March 2019 from https://www.healthdirect.gov.au/medicines/brand/amt,3677011000036106/keppra

(April 2016) Levetiracetam. MedlinePlus. Retrieved March 2019 from https://medlineplus.gov/druginfo/meds/a699059.html

(August 2013) Apparent dose-dependent levetiracetam-induced de novo major depression with suicidal behavior. Epilepsy & Behavior Case Reports. Retrieved March 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4150644/

(February 2015) Zonisamide, Topiramate, and Levetiracetam: Efficacy and Neuropsychological Effects in Alcohol Use Disorders. Journal of Psychopharmacology. Retrieved March 2019 from https://dash.harvard.edu/bitstream/handle/1/13581232/4276485.pdf?sequence=1

(February 2019) Prescription Drugs. National Institute on Drug Abuse for Teens. Retrieved March 2019 from https://teens.drugabuse.gov/drug-facts/prescription-drugs

(July 2012) Postmortem Levetiracetam (Keppra) Data from North Carolina. Journal of Analytical Toxicology. Retrieved March 2019 from https://academic.oup.com/jat/article/36/6/422/793655

(January 2018) Human abuse potential of brivaracetam in healthy recreational central nervous system depressant users. Epilepsy & Behavior. Retrieved March 2019 from https://www.epilepsybehavior.com/article/S1525-5050(17)30308-6/abstract

(January 2019) Epilepsy. Mayo Clinic. Retrieved March 2019 from https://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093

(March 2015) Feeling high/drunk on Keppra? Reddit. Retrieved March 2019 from https://www.reddit.com/r/Epilepsy/comments/2p5mjs/feeling_highdrunk_on_keppra/

(December 2011) MEDICATION GUIDE KEPPRA® (KEPP-ruh) (levetiracetam) tablets and oral solution. Food and Drug Administration. Retrieved March 2019 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021035s052s073s074s083s085,021505s019s020s025s026mg.pdf

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