Keppra Side Effects

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Levetiracetam, also known as Keppra, is a prescription medicine used alone or in combination with other medications to manage seizures. [1] The medication can help people control different types of seizures, including juvenile myoclonic epilepsy, generalized tonic-clonic seizures, and partial onset seizures. With a different chemical composition from other antiepileptic drugs, Keppra decreases certain brain chemicals that transmit signals between nerves. With this mechanism, the drug can make uncontrollable firing between nerves less likely, reducing the risk of seizures.

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While Keppra can be extremely beneficial for controlling seizures, its use does not come without side effects. While most Keppra side effects are mild and tolerated, they can sometimes before severe. All new and old users of this medication must familiarize themselves with these side effects and learn when to contact a doctor.

Overview of Keppra Side Effects

Like other medications, Keppra is likely to cause side effects ranging from mild to severe in intensity. These side effects involve any unwanted response that occurs when the medication is taken in normal doses. The most common Keppra side effects reported by users taking the medication follow. Remember that these side effects may not occur in every user, and some may go away without treatment.

  • Decreased appetite
  • Drowsiness
  • Dizziness [2]
  • Weakness
  • Hair loss
  • Infections, such as the common cold

A pharmacist or a doctor can help you manage the side effects mentioned above if they do not go away on their own. In addition to these adverse effects, Keppra may cause some less common problems in users. These problems mentioned below require an appointment with the doctor as they carry the potential to cause complications:

  • Abnormal thoughts or behavior, including paranoia and hallucinations
  • Mood or behavior changes (for example, aggression, rage, hostility, anxiety, and excitation)
  • Memory loss
  • Muscle pain or weakness (especially if occurring simultaneously with passing dark urine)
  • Unexplained bruising
  • Problems with muscle control and coordination
  • Signs of bleeding (including bloody nose, coughing up blood, blood in urine, bleeding gums, and difficulty stopping blood from minor cuts
  • Signs of infection (such as fever or chills, prolonged dizziness, shortness of breath, headache, weight loss, and listlessness)
  • Signs of a depressive disorder (such as poor concentration, changes in sleep, weight changes, suicidal thoughts, and a decreased interest in activities)
  • Toothache

Stop taking Keppra at once and seek medical attention immediately if you feel the following side effects developing:

  • Signs of a severe skin reaction, for instance, peeling or blistering of the skin, development of a rash covering a large area of the body, a rash that quickly spreads over the body, or a rash with fever or discomfort
  • Worsening seizures
  • Symptoms of an allergic reaction (e.g., hives, difficulty breathing, itchy skin rash, or swelling of the tongue, mouth, or throat)
  • Thoughts of suicide or hurting yourself

Some people may experience more side effects than others, as everyone has different body chemistry and respond differently to the medication.

Minimizing Keppra Side Effects: Warnings to Keep in Mind

Before you start using Keppra, make sure to inform your doctor about any underlying allergies or medical conditions.  It is also imperative, to be honest about all prescription and non-prescription medications you are currently taking and whether you are pregnant or trying to get pregnant in the future. All these factors can affect how you should use Keppra to minimize side effects.

Following are some drug warnings to keep in mind if you are starting to use Keppra for seizure management:


Keppra can cause a drop in the number of red blood cells, leading to symptoms of anemia. These symptoms may include having pale skin, feeling unusually tired, and shortness of breath.  If you notice any of these symptoms, contact a doctor to get a blood test done and confirm if you have developed anemia.

Behavior problems

Many people have reported feeling behavioral changes associated with Keppra use. [3] Occasionally, the drug may also lead to anxiety, aggressiveness, mood swings, and hostility. If you start experiencing any of these symptoms, talk to a doctor urgently before they become serious.

Blood pressure considerations

Keppra is also used for seizure management in children. The medication carries the potential to cause high blood pressure, especially in children of one to four months. Ensure that you are monitoring your child’s blood pressure if they are on this drug.

Drowsiness/altered alertness

People suffering from uncontrolled epilepsy are not advised to handle dangerous machinery or drive. Such people, especially those on Keppra, must be more cautious as the medication can cause muscle control and drowsiness issues. Hence, avoid participating in activities that require physical coordination or mental alertness until you have discovered how the medication affects you.

Heart rhythm

Keppra can rarely cause changes in the heart rhythm. People using this medication must immediately report to a doctor if they feel their heartbeat getting irregular or slower or if they develop shortness of breath. Those with a pre-existing heart issue or on other medications that affect the organ must discuss with a doctor regarding the safety of starting Keppra.

Hypersensitivity syndrome

Some people have reported experiencing hypersensitivity syndrome while using Keppra. This severe allergic reaction can be life-threatening, so getting medical help can be lifesaving. Some common symptoms of hypersensitivity syndrome include fever, yellowing of the eyes and skin, swollen glands, and other flu-like symptoms with skin blistering or rashes.


Levetiracetam can decrease the number of white cells, a type of blood cell that act as a wall of defense, fighting different infections. If you feel fatigued, weak, or develop a fever or sore throat while using this medication, contact a doctor. A doctor may consider carrying out certain investigations or changing the medication if you encounter infections.

Kidney disease

Kidneys are responsible for getting rid of Keppra and other medications from the body. Hence, people suffering from kidney disease or decreased kidney functions may start accumulating this medication. This may put them at an increased risk of an overdose. If you have a kidney issue or other problems with the kidneys, talk to a doctor if taking Keppra is safe for you. Depending on the nature and severity of the disease, a doctor may reduce the dosage or shift you to a safer alternative. Some people may also require regular kidney monitoring to ensure that Keppra is not harming the kidneys.

Liver function

Keppra can cause liver inflammation and failure in rare cases. Hence, a doctor may monitor the liver functions occasionally to monitor how the organ functions. If you already suffer from liver disease or deranged liver function, ask your doctor if taking Keppra is safe for you and how your pre-existing disease can affect its dosage and frequency of use. Depending on the severity, a doctor may also determine how frequently they should monitor the liver function.

Suicidal thoughts and behavior

Very rarely, using levetiracetam or Keppra can make users experience suicidal thoughts. If you experience any of these symptoms or other unusual behavioral changes while on this medication, contact a doctor immediately.


Keppra is known to cause harm to the developing baby if a pregnant woman takes it. Hence, its use during pregnancy is only advised if the benefits significantly outweigh the risk. If you find out you are pregnant while using Keppra, contact a doctor immediately.


Keppra can pass into breastmilk; hence, it can affect the baby if taken by feeding mothers. Hence, you must talk to a doctor if you are breastfeeding regarding the safety of this drug.

Keppra Withdrawal: What it Looks Like

While levetiracetam is not known to cause physical dependence, people who have been using it for a long time may be at risk of developing withdrawal. One of the most common Keppra withdrawal symptoms includes the recurrence and potentially increased incidence of seizures. Some people who abruptly stop using the medication may develop a prolonged, severe seizure called status epilepticus.

There is no known data about the potential Keppra withdrawal timeline, as it may differ for different people. Some people may have to restart taking the medication as the danger is too high. If someone needs to get off the drug, the best way is to contact a doctor who will evaluate their case and determine an appropriate tapering schedule. This tapering schedule is not fixed and varies according to the current dose of Keppra, the duration of use, and the severity of the underlying epileptic issue. In general, it takes a few months for a person to safely taper off Keppra.


Can Keppra cause side effects in pregnant females?

In the United States, the FDA has assigned Keppra Category C, meaning users must practice caution while using it. The benefits generally outweigh the risks; however, using levetiracetam can increase the risk of neural tube side effects, such as spina bifida. Hence, an expert must carefully evaluate the risks with benefits to determine if using the medicine is critical for a pregnant woman. If indicated, such women usually take a fixed dose of folic acid to reduce the risk of Keppra side effects.

Who should not take Keppra?

Certain people are at an increased risk of experiencing Keppra adverse effects, such as those who experienced an allergic reaction to the medication before. Such people must steer clear of this drug. Additionally, people with kidney issues must also be careful about the dosage of Keppra they use to avoid burdening their bodies with excessive medication.

How soon do Keppra side effects in adults begin?

Many mild to moderate issues can start occurring during the early phase of treatment, such as diarrhea, vomiting, mood changes, and behavioral alteration. Allergic reactions to levetiracetam usually occur right after the first dose; however, other serious reactions may take a few weeks of daily usage to appear. The serious side effects, such as weakness, blood disorders, infections, and other Keppra behavioral side effects, typically take a few weeks or even months to become a significant issue.

How long will Keppra side effects last?

Most mild effects typically improve over time on their own, but some of them, including infections, may come and go in a recurring pattern. Discontinuation of the drug leads to the resolution of most side effects. However, remember that it is never wise to stop using levetiracetam abruptly if it is causing too many side effects. If these side effects are bothering you, talk to a doctor and seek advice. Depending on the circumstances, the doctor may reduce the dose, space out the daily dosage, or even stop the drug and swap it with an alternative.

Is there a chance of developing Keppra side effects long term?

Many people continue using Keppra for years to manage their seizures. While the drug can cause long-term side effects, most are manageable and tolerable as long as the medication works. If any of the side effects become intolerable, contact a healthcare professional.

Can Keppra cause headaches?

Many people report experiencing a pressure buildup in the head, similar to a headache.

Do Keppra side effects go away?

Most mild side effects due to Keppra settle on their own as the body becomes accustomed to using the medication. The ones that persist are usually within a tolerable range, and most people can continue their usual medication without any issues. However, if any of the side effects become too severe or unbearable, you must seek professional advice instead of stopping the medication yourself.


[1] Kumar A, Maini K, Kadian R. Levetiracetam. InStatPearls [Internet] 2022 Jun 24. StatPearls Publishing.

[2] Verrotti A, Prezioso G, Di Sabatino F, Franco V, Chiarelli F, Zaccara G. The adverse event profile of levetiracetam: a meta-analysis on children and adults. Seizure. 2015 Sep 1;31:49-55.

[3] Ogunsakin O, Tumenta T, Louis-Jean S, Mahbub A, Rabel P, Olupona T, Alam S. Levetiracetam induced behavioral abnormalities in a patient with seizure disorder: a diagnostic challenge. Case reports in psychiatry. 2020 Aug 18;2020.

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