Levetiracetam (Keppra): What You Need to Know
Levetiracetam is a commonly prescribed anticonvulsant used to treat seizures in adults and children. Doctors often pick it because it works for many types of epilepsy and has fewer drug interactions than older seizure medicines. You’ll see it as brand-name Keppra or as generic levetiracetam.
How it works: Levetiracetam modulates brain signaling to reduce seizure activity. The exact mechanism isn’t fully known, but clinical trials show it lowers seizure frequency for focal seizures, generalized tonic-clonic seizures, and myoclonic seizures.
Typical dosing and how to take it
Adults usually start low and increase slowly. Common starting doses are 500 mg twice daily, rising to 1000 mg twice daily depending on response. For children, dosing is weight-based. There’s an oral tablet, an extended-release tablet (once daily), and a liquid. Take it at the same times every day. You can take levetiracetam with or without food. If you miss a dose, take it as soon as you remember unless it’s near the next dose — don’t double up.
Side effects, warnings, and monitoring
Most people tolerate levetiracetam well, but expect possible side effects like drowsiness, dizziness, weakness, and irritability. Some people experience mood changes, depression, or aggression. If you notice new or worsening mood symptoms, contact your doctor right away. Kidney function matters: levetiracetam is cleared by the kidneys, so doctors reduce the dose for people with kidney problems.
Interactions are limited compared with many antiepileptics, but always tell your provider about other meds, especially other seizure drugs and sedatives. Alcohol can increase sedation and should be limited. If you’re planning pregnancy or breastfeeding, discuss risks and benefits with your doctor — some people continue treatment because uncontrolled seizures can be risky during pregnancy.
Switching between formulations (immediate vs extended release) is possible but should be guided by a clinician. Don’t stop levetiracetam suddenly; abrupt withdrawal can trigger seizures. If stopping is planned, your doctor will taper the dose over weeks.
Practical tips: Keep a seizure diary to track frequency and triggers. Take your medication at the same times each day to avoid missed doses. Store at room temperature away from moisture and out of reach of children. If you experience severe rash, fever, or signs of infection, seek medical help.
Questions to ask your provider: Is this the best option for my seizure type? What dose will you start with and how fast will you increase it? How should we adjust the dose if I have kidney issues? What side effects should I watch for?
Levetiracetam is effective for many people with epilepsy and is easy to use. Work closely with your healthcare team to find the right dose and to manage side effects. If anything doesn’t feel right, call your clinician — quick action keeps treatment safe and effective.
Remember to carry a list of your medications and allergies. If you have a seizure emergency plan, share it with family. Regular follow-up lets your doctor adjust therapy and protects your safety. Ask when unsure.
May, 16 2023