Keppra-XR Index
Crazy Meds Comprehensive Keppra-XR pages

This is our basic overview of Keppra-XR (levetiracetam). Clicking on a “More…” link will take you to a page with greater detail. The Comprehensive Keppra-XR pages contain all of the information from all of the “More…” pages, but with less explanatory material.

1.  Brand & Generic Names; Drug Class

US brand name:	Keppra-XR
Generic name:	levetiracetam
What is Keppra-XR (levetiracetam)?	Keppra-XR (levetiracetam) is in the AntiepilepticDrugs/Anticonvulsants class of drugs.

More about Keppra-XR’s generic availability, worldwide trade names, and more

2.  What is Keppra-XR (levetiracetam) used for

2.1  US FDA approved treatment(s)

XR: as an add-on for partial onset seizures. IR & injection: add-ons for partial & generalized seizures, and for JME.

2.2  Popular off-label uses

Using Keppra by itself for partial & generalized seizures and JME. Absence seizures, seizures and other damage caused by traumatic brain injury, Lennox-Gastaut syndrome, and various other forms of epilepsy and seizure disorders. Like most AEDs Keppra is used off-label to treat migraines, neuropathic pain, bipolar disorder, anxiety disorders, and substance abuse/addictions.

More about Keppra-XR approved & off-label uses

3.  When will Keppra-XR (levetiracetam) start working?

3.1  How long until Keppra-XR starts working

Not very. Like, as in two days not very. Even for refractory epilepsy Keppra can start working in one day.

3.2  Will Keppra-XR really work for what I have?

As an add-on for epilepsy, pretty good. About half the people who take it have their seizures reduced by at least 50%, and most of them keep taking it after three years.
Where Keppra really shines is for people with refractory (otherwise uncontrollable) epilepsy. The chances of working are almost as good: around 40% of people who take it have their seizures reduced by half, and some become seizure-free.

More about how long until, and how well will Keppra-XR work; and how Keppra-XR compares with other drugs

4.  How to take and stop taking Keppra-XR (levetiracetam)

4.1  How to take Keppra-XR

According to UCB you can start Keppra XR at 1000mg once a day and that’s it, sort of like Invega. They said the say thing about the immediate-release version as well, although with two 500mg doses. Although 500mg is the low-end of the therapeutic range. If you haven’t achieved symptom control, or you lose symptom control, your doctor may increase your dosage by 1000mg a day (taken once a day for KeppraXR and two 500mg doses for immediate-release Keppra) each week until you hit the maximum recommended dosage of 3000mg a day.
Guess what? I disagree.
UCB makes 250mg tablets for a reason, and Keppra immediate-release Keppra is really easy to split in half. So 500mg a day is probably a much better place to start. Hell, they don’t even make a 1000mg XR tablet!
And one week means seven days, not five.
Even though the XR is supposed to be once-a-day dosing and the IR twice-a-day, you may want to consider three-times-a-day (TID) dosing for IR and twice-a-day (BID), maybe even TID dosing to deal with any psychiatric side effects.

4.2  How to stop taking Keppra-XR

Slowly, unless being on Keppra is sucking serious ass. And this is why I don’t like starting a med at a therapeutic dose. OK. End soapbox. Generally, the way you went up—was it in 250mg increments, 500mg increments? Please say it wasn’t in 1000mg increments. How you went up on Keppra is how you should go down from Keppra —500 to 250 every 5 to 7 days.

More about taking and discontinuing Keppra-XR

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5.  Keppra-XR’s (levetiracetam’s) pros and cons

5.1  Pros

Low side effect profile. As in fewer side effects than the placebos in several of the clinical trials. Much less chance of your flipping out on it when compared to other anticonvulsants (E.g. Keppra: 10% of epileptics with previous histories of psychiatric or serious epileptic flippage had issues. Topamax: 24% of similar people had issues.) Tends to make people smarter, not dumber like most anticonvulsants. Even people starting with learning disabilities can get a bit of a boost. Also, unlike many anticonvulsants it’s so easy on your liver you can take it after a freaking liver transplant! It starts working right away, and many people can start at or near the therapeutic dose if required-it was designed that way. One researcher describes it as having, “close to ideal pharmacokinetic properties.”

5.2  Cons

A lot of the side effects it does have are psychiatric. Reports from the field (a.k.a. anecdotal evidence) suggest the most common are the deep, sometimes suicidal depression. Another favorite is the Keppra rage, although this one seems to be overhyped, and the XR version may have dealt with that for many people in any event. Far less frequent, but still reported, are hallucinations - one woman I know with epilepsy had deep philosophical conversations with a ghost every night. And there’s this case report of a kid getting a bit psychotic on Keppra. Those kind of suck-especially when no one bothers to warn you that they might happen.

5.3  Interesting stuff your doctor probably didn’t tell you

Keppra doesn’t mess with, like, anything. In that it has practically no drug-drug interactions. That in and of itself is pretty interesting. Girls get more bang for their buck than boys with Keppra. Per the PI sheet women absorb 20% more of Keppra than men do. Keppra is by far the worst tasting pill on the market. Everyone who whines about how bad Lamictal tastes should lick a split Keppra. Then a split Topamax. Topamax’s taste warrants a mention in its PI sheet (although it turns out you’re not supposed to split Topamax because that hoses its rate of absorption, and isn’t really about the taste), and Keppra tastes even worse. All the other super interesting stuff is really geeky and belongs on other pages
More of Keppra-XR pros, cons, and interesting stuff

6.  Keppra-XR (levetiracetam) side effects

6.1  Typical Keppra-XR side effects

Like most AEDs: sleepiness, headache, and dizziness/vertigo. What most crazy meds have as uncommon-to-rare, but are common side effects for Keppra: Muscle weakness and various kinds of infections-rhinitis, pharyngitis, sinusitis, and assorted nose problems.

6.2  Uncommon Keppra-XR side effects

The mood problems-depression, psychosis, hostility, anxiety in various forms (I know, it’s supposed to be good for anxiety. But yet…drugs are weird…). Appetite changes one way or another. Paresthesia, aka that fun tingling in your extremities like Topamax does.

6.3  Freaky rare Keppra-XR side effects

Peace-Love-and-Fluffy-Bunnies-Not-Manic-Just-Happy! OK, so Kassiane may have been the only one who got that for very long. Fungal infection. Gingivitis. The personal hygiene supply companies have a big market with people taking anticonvulsants.
More about Keppra-XR side effects

7.  What Keppra-XR (levetiracetam) is best known for

Being the AED that will either fix you when nothing else can, or kill you because it’ll make you suicidally depressed and/or so enraged at the world that you’ll die because half-a-dozen cops had to tase you.
More about Keppra-XR black box warnings, noted traits & effects

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8.  Keppra-XR (levetiracetam) half-life & how long until Keppra-XR clears your system

Half-lives IR: 6 to 8 hours, XR: 7 hours (BFD). Clearance: 1–2 days. It goes in fast, it goes out fast.
Drugs.com’s drug-drug and drug-food interaction checker
More about Keppra-XR pharmacokinetics & noted drug-drug & drug-food interactions

9.  How Keppra-XR (levetiracetam) works (the best current guess at any rate).

You know how very few AEDs work the same way? Keppra is way more different than all of them. It binds to synaptic vesicle protein 2A (SVP2A) ligands (in English: reduces whatever the hell neurotransmitters or something else interacts with your brain via that stuff) and by doing so stabilizes any imbalance of the potassium and calcium voltage channels. This happens mostly in the hippocampus and amygdala, the latter of which explains the profound mood effects.
More about how Keppra-XR works. AKA Keppra-XR mechanism/method of action, or pharmacodynamics.

10.  Comments

Keppra, Keppra, how I love my Keppra. My favorite anticonvulsant ever, and I’ve been on quite a few. Not only was my refractory epilepsy controlled for the first time ever, but Keppra made me happy. Yes, you read that right. Happy. Maybe that’s the effect of dekindling. I don’t know. But I was really cheerful, and my general anxiety was really low-OCD was bad, like, pull off the keys off the keyboard bad, but I can live with that. I was sleeping. And I got back cognitive skills I lost in the car accident I was in back in March 2005 - complex things like adding and subtracting 2 digit numbers so I don’t need to ask the bank people do to it. Keppra is brain miracle in a little yellow pill.
It appears that, like many anticonvulsants, if what Keppra does is what you need, then you don’t get the cognitive side effects, only for this med those side effects are psychiatric not “me feel stupid.” Or that could be me talking out my ass again.
If Brain/Pain Doctor Of Choice is suggesting you try Keppra it’s worth a shot; especially if someone is around to make sure you don’t completely flip your shit. Based on everything on various support forums, it’s a med that either you love or you hate.
More comments As if I didn’t go on long enough here.
Consumer/patient comments about & experiences with Keppra-XR

11.  Discussion board, PI sheet and other allegedly useful links

Crazy Meds’ Keppra-XR discussion board
Keppra-XR’s Full US Prescribing Information / PI Sheet
Allegedly Useful Links. Mostly any official sites we could find for this med and PI sheets from countries other than the US.

Keppra-XR Index
Crazy Meds Comprehensive Keppra-XR pages

Bibliography

Date created Tuesday, 04 October 2011 at 11:12:28 Page Author: Last edited by: JerodPoore

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Keppra-XR Basic Overview by is copyright 2011

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¹ While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.

² Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?
[begin rant] I rent a dedicated server for Crazy Meds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had the forerunner to QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]