Keppra-XR Index | Expanded Brand, Generic & Availability ›
Crazy Meds Comprehensive Keppra-XR pages

This is our basic overview for Keppra-XR, and is a brief summary of what we know about it. Clicking on a “Read more…” link will take you to a page with greater detail. The Comprehensive Keppra-XR pages contain the information from all of the “Read more…” pages.

1.  Brand & Generic Names; Drug Class

US brand name:	Keppra-XR
Generic name:	levetiracetam
Drug class:	AntiepilepticDrugs/Anticonvulsants

Read more about Keppra-XR’s brand & generic names, and availability

2.  Approved and off-label uses of Keppra-XR (levetiracetam)

2.1  US FDA approved use(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.

Read more of Keppra-XR’s approved & off-label uses

3.  Keppra-XR’s (levetiracetam’s) Pros and Cons

3.1  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.”

3.2  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.

3.3  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
Read more of Keppra-XR’s pros, cons, and interesting stuff

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4.  Keppra-XR’s (levetiracetam’s) Side Effects

4.1  Typical 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.

4.2  Uncommon 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.

4.3  Freaky rare 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.
Read more of Keppra-XR’s side effects

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

5.1  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.

5.2  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.
Read more about taking and discontinuing Keppra-XR

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

6.1  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.

6.2  Chances of Keppra-XR working

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.
Read more about Keppra-XR’s efficacy & comparisons with other medications

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.
Read more of Keppra-XR’s noted traits, effects, and warnings

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8.  Keppra-XR’s (levetiracetam’s) half-life & how long until it 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
Read more about Keppra-XR’s 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.
Read more about Keppra-XR’s 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.
Read more comments
Read consumer/patient comments about & experiences with Keppra-XR

11.  Discussion board, PI sheet and other useful links

Crazy Meds’ Keppra-XR discussion board
Keppra-XR’s Full US Prescribing Information / PI Sheet
Useful Links

Keppra-XR Index | Expanded Brand, Generic & Availability ›
Crazy Meds Comprehensive Keppra-XR pages

Bibliography

Common and not-so-common misspellings. Because even Google needs help sometimes. And the least we can do is share the creativity expressed by people in their quest for information about neuropsychiatric medications.
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Date created Tuesday, 04 October 2011 at 11:12:28 Page Creator: Kassiane S. Last edited by:

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Keppra-XR Basic Overview is copyright 2011 Kassiane S.

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