Keppra and epilepsy - your questions answered

  • October 5, 2023
  • 6
In this article
Colourful medication on a blue background

Are you taking Keppra for seizures? Whether your doctor has only just prescribed it, or you’ve been taking it for some time, you might have questions about this epilepsy medication.

Here’s everything you need to know about Keppra for seizures. 

What is Keppra?

Keppra is an anti-seizure medication. Another brand name is Spritam. It is also known by its generic name levetiracetam. According to ClinCalc, almost 1.5 million people in the US take levetiracetam in one form or another. 

Keppra is one of the ‘new’ generation of epilepsy medications, and was first approved by the FDA in the year 2000. At present, it is only approved as an adjunctive epilepsy treatment in the USA. This means it can only be used at the same time as another anti-seizure medication (in some other countries it’s been approved for use on its own). 

Keppra is usually taken twice daily, and most often comes as a pill. It can also be injected, taken in liquid form, or crumbled into food.

What is Keppra used for?

In the US, Keppra is used as an add-on therapy to treat a variety of types of epilepsy:

Because it is an adjunctive therapy, you will take it with another ‘first line’ seizure medication. 

How does Keppra work?

Scientists still don’t fully understand how Keppra works for treating seizures. But one reason it is widely used as an adjunctive medication is that it seems to work on a different part of the brain to other kinds of anticonvulsants.  

Most anticonvulsants work by slowing down the way your brain sends electrical signals. But Keppra seems to target a different part of the brain. This means it doesn’t interact with the other medication you take, and gives you more protection. 

Keppra side effects

One of the main advantages of Keppra is that, for most people, it has few (if any) side effects. You may experience mild side effects when you begin using Keppra for seizures, but these often go away after a couple of weeks. 

It’s important to be aware of Keppra’s common and rare side effects. All this information will be provided in the patient leaflet that comes with your prescription:

Common mild side effects of Keppra for seizures 

  • Cold-like symptoms, such as blocked nose or itchy throat
  • Drowsiness or sleepiness
  • Feeling dizzy
  • Having headaches
  • Feeling more aggressive or irritable
  • Feeling sick

Rare but serious side effects of Keppra for seizures

  • Suicidal thoughts
  • Kidney problems (not going to pee much, swollen legs, ankles or feet)
  • Pregnancy problems (Keppra may affect the development of babies in the womb)

Who can take Keppra for seizures?

Keppra can be used to treat people of all age groups, from infants to children, teens through to adults. The amount of Keppra children take depends on their age and weight. People aged 16 and above normally begin on around 250 mg per day, before increasing the dose over a couple of weeks. 

Who shouldn’t take Keppra for seizures?

Some people shouldn’t begin taking Keppra, including:

  • Anyone who’s had an allergic reaction to Keppra ingredients in the past (check the leaflet in the box)
  • Anyone with a kidney problem
  • People who have depression or who have thought about committing suicide
  • Pregnant women, or women planning to get pregnant (but you shouldn’t stop taking Keppra suddenly if you find out you’re pregnant as this increases your risk of seizures. Talk to your doctor about your pregnancy and Keppra). 

Taking Keppra for seizures

You should take Keppra as your doctor or pharmacist instructs. The exact amount you take will depend on your age. 

  • People aged 16 and above: You’ll typically start two doses of 500mg a day, according to, an independent website. Your doctor may then increase dosage over a few weeks, up to a maximum of 3000 mg daily. 
  • For children and teens: Dosage depends on the child’s weight, age, and the brand of levetiracetam the doctor has prescribed. 

Can missing one dose of Keppra cause a seizure?

Potentially, yes. Although for most people, missing a single dose will not trigger a seizure, it could increase the risk. The leaflet that comes with the medication should tell you what to do if you miss a dose, but the following tips from the NHS can help:

  • If you take one dose per day, take the missed dose as soon as possible - unless it’s less than 12 hours until you normally take your next dose. If so, wait and take your next dose at the normal time. 

Example: You normally take your dose at 9am. If you realize you forgot your dose at 11am, take the dose now. But if you only realize you forgot the dose at 10pm, just wait until your normal dose tomorrow morning. 

  • If you take two doses per day, take it as soon as you remember, unless it’s less than eight hours until you need to take the second dose. If so, wait and take the second dose at the normal time. 

Example: You take Keppra at 7am and 7pm. If you realize you forgot your dose at 10.30am, take the first dose now. But if you only realize at 3pm, just wait until 7pm to take your regular dose.

You shouldn’t double the dose if you forget to take your Keppra.  

In depth: What happens if you miss a dose of seizure medication?  

Chances of having a seizure on Keppra

Taking Keppra will not stop all seizures for all people. But several studies have shown it is effective at reducing the number of seizures you may have. And for some people, Keppra can help them achieve seizure freedom. 

For example, a study by UCB, the company that produces Keppra, found that 72.2% of patients who took Keppra had a 50% reduction in seizures over a 20 week period. And 24.1% became seizure free. 

What if you’re still having seizures while on Keppra?

If you’re still having seizures while on Keppra, this can be very frustrating. In the first few weeks of taking any anticonvulsant, it may take a while for the medication to begin working correctly. During this time, speak to your doctor and they may increase your dosage. 

But if you have been taking Keppra for several months and keep having seizures, it may mean it isn’t working for you. While seizure medication can help many people, about a third of people with epilepsy have seizures that cannot be stopped by medication alone

If seizure medication isn’t working for you, there are alternative treatment options that can also help control your seizures. Speak with your physician about alternatives when you next go for an appointment. 

Suggested: What are the main epilepsy treatment options?

Your journey to seizure freedom

Millions of people around the world take Keppra for seizures, and this medication can clearly play an important role in helping some people achieve seizure freedom. 

If you are taking Keppra (or another levetiracetam brand), you might find it helpful to keep a seizure diary. With Epsy, you can set reminders to take your medication, note down any side effects or missed doses, and record any seizures too. You can even share this information with your treatment team. Try Epsy for free  today

Share article

Get the #1 epilepsy app now

Read next