Levetiracetam: what it treats, how to take it, side effects
Last updated September 3, 2026.
Levetiracetam is an anticonvulsant that controls seizures by decreasing abnormal excitement in the brain. You may know it as Keppra. It is one of the most prescribed seizure medications because it plays well with other drugs - and its most-discussed side effect is what it can do to mood.
What does it treat?
Partial-onset seizures, alone or with other medications, in adults, children, and infants 1 month and older; juvenile myoclonic epilepsy in those 12 and older; and primary generalized tonic-clonic seizures in those 6 and older, both in combination with other medications.
How do you take it?
Twice a day, morning and night, for the tablets, liquid, and suspension tablets; once daily for the extended-release tablet - with or without food, same times every day. Your doctor starts low and increases no more than once every 2 weeks. Swallow tablets whole, never split, chew, or crush. Suspension tablets dissolve on the tongue with a sip of liquid (about 10 seconds) or in a tablespoon of water - drink right away. Measure the liquid with a proper device, not a kitchen spoon. It controls epilepsy but does not cure it, so keep taking it even when seizure-free. Never stop suddenly: seizures can worsen - your doctor tapers gradually. Missed dose: take it within a few hours if you remember, otherwise skip; never double up.
Side effects to know
- Common: weakness, unsteady walking, dizziness, confusion, irritability, aggression, headache, loss of appetite, vomiting, diarrhea, constipation, excessive sleepiness, joint pain, neck pain, double vision, and nasal congestion. The irritability and aggression deserve their own mention - mood changes are this drug's known signature, tell your doctor if they show up.
- Serious: rash with fever, swollen lymph nodes, facial swelling, shortness of breath, yellowing skin or eyes, or dark urine; seizures that are worse or different than before; fever, sore throat, or other signs of infection; blisters, hives, or itching; facial, throat, tongue, lip, or eye swelling; trouble swallowing or breathing; and loss of balance or coordination. The anticonvulsant class warning applies: about 1 in 500 people in studies became suicidal during treatment - watch for panic attacks, agitation, new or worsening depression or irritability, aggression, mania, and any talk of self-harm, with family briefed on the signs.
Who should not take it?
Flag kidney disease (it changes dosing), depression, mood problems, and any past suicidal thoughts or behavior. It can make you dizzy and drowsy - no driving until you know how it affects you. Pregnancy and breastfeeding need a direct call with your doctor - do not stop on your own if you become pregnant, since uncontrolled seizures carry their own risk.
When is it an emergency?
Call 911 for trouble breathing or swallowing, facial or throat swelling, or a seizure that does not stop. Rash with fever and swollen glands, and yellowing skin or eyes, mean immediate care. Any thought of harming or killing yourself means calling your doctor right away, or call or text 988, the Suicide and Crisis Lifeline, any time. For an overdose, call Poison Control at 1-800-222-1222. Pymander's escalation routing is built and tested specifically for this class of decision; see the safety architecture working paper.
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Common questions
Why does levetiracetam affect mood?
Irritability, aggression, and mood changes are among its most common effects - they sit on MedlinePlus's common side effect list, and the class warning covers deeper changes including suicidal thoughts in about 1 in 500 people in studies. Family and partners often notice first - brief them, and report changes to your doctor rather than waiting them out.
How is levetiracetam different from older seizure medications?
Mostly the interactions - or lack of them. Levetiracetam is known for playing well with other medications, which is why it is often the first add-on or first choice when someone takes multiple drugs. It still needs twice-daily dosing for the immediate-release forms and the same never-stop-suddenly rule as every anticonvulsant.
Why can't I stop levetiracetam suddenly if I feel fine?
Because feeling fine is the medication working. MedlinePlus says it controls epilepsy but does not cure it, and stopping suddenly can make seizures worse - your doctor decreases the dose gradually if it is ever time to come off. Seizure-free months are the goal state, not the exit signal.
Can I drink alcohol while taking levetiracetam?
Neither the label nor MedlinePlus lists a specific alcohol interaction. Alcohol lowers the seizure threshold on its own and stacks with the dizziness and sleepiness this drug can cause - most neurologists tell patients on anticonvulsants to keep it minimal or skip it. Ask yours directly.
What happens if I miss a dose of levetiracetam?
MedlinePlus's rule: if it has only been a few hours, take it when you remember; if it is almost time for the next dose, skip it, and never double up. Consistency matters more with seizure medication than almost anything else - a phone alarm for both daily doses is worth setting.
Does levetiracetam interact with birth control or other medications?
It is one of the cleaner anticonvulsants for interactions - unlike topiramate and lamotrigine, it is not flagged for reducing hormonal contraceptive effectiveness. But MedlinePlus still wants your full medication list with your doctor and pharmacist, since some medications need dose changes or monitoring alongside it.