How often does Levetiracetam cause mood changes?

Question

Hello doctor,

I am a 27-year-old male. I have experienced two seizures in the past six months. My latest EEG scan has shown abnormalities on the left side of my temporal lobe. I have been under treatment with Levetiracetam 500 mg twice a day.

I have recently been suffering from mood swings and fatigue. My liver enzymes and electrolytes were found to be within the normal range.

Is this caused by any side effect of Levetiracetam?
If yes, is there any other medicine that can be taken with fewer chances of behavior-related side effects?

Thanks in advance.

Answer 1

Hello,

I hope you are doing well.

I understand all your worries.

Having considered your information, it seems that you suffer from a Levetiracetam (Keppra) reaction. While it is one of the most effective drugs that can be used to control seizures, certain individuals may have mood alterations, irritation, anxiety, or fatigue. The reason why it is probably not related to your liver and electrolyte values is that they are normal in your case.

Various other anti-seizure drugs can be suggested as an alternative to Levetiracetam, depending on the type of seizures, results of EEG(electroencephalogram), and other medical conditions. They are:

Brivaracetam: Like Levetiracetam, yet with less potential to affect mood and behavior.
Lamotrigine: A well-tolerated drug, which may also have mood-stabilizing effects, thus can be an appropriate choice for certain patients who have temporal lobe epilepsy.
Oxcarbazepine and Lacosamide: Can be used as an alternative as well.

In any case, it is necessary to take this medication precisely according to instructions. Sufficient sleep, staying well hydrated, avoiding alcohol intake, and ensuring no dose skip should be practiced to avoid the occurrence of seizures.

Please do not attempt to stop or change the medication you are on without prior discussion with your neurologist, as this will make you susceptible to having seizures. Discussion with your neurologist can help you decide whether you need a change in dosage or a change of medication to Brivaracetam.

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Thank you.