Keppra rage is rare, but can be very real for seizure patients

The widely used anti-seizure medication Keppra can cause rare but serious behavioral side effects, including what users of the drug have called “Keppra rage.”

Author: David Steen Martin; Reviewed by Rebekah J. Woods, D.O.

Published: January 2, 2024

The widely used anti-seizure medication Keppra can cause rare but serious behavioral side effects, including what users of the drug have called “Keppra rage.”

“It’s important to let your health care provider know right away if you have any mood changes on Keppra,” said Rebekah J. Woods, D.O., neurologist, Norton Neuroscience Institute.

Some epilepsy patients taking Keppra experience “seething rage, uncontrollable anger, fits of fury and violence.”

In addition to aggression, Keppra can cause depression and suicidal tendencies. One study found that one in every 530 Keppra users reported suicidal thoughts.

Overall, serious side effects with Keppra are unlikely. These side effects appear to occur more frequently in people who have had prior issues related to mood or mental health, including psychosis.

Other, less serious behavioral side effects with Keppra include irritability, agitation, aggression, anxiety, apathy, hostility and nervousness. One or more of these side effects were experienced by 13% of adult patients taking Keppra and 38% of children taking the drug.

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Because seizure medications act on the brain, everyone responds to them a little bit differently. It is impossible to predict which side effects you will experience on a particular anti-seizure drug.

Side effects tend to be worse if the dosage is increased too fast or if there is too much of the drug circulating in your blood, according to the Epilepsy Foundation. Because of this, doctors generally prescribe a lower dose and increase the dosage as needed.

If you do experience Keppra rage, your health care provider may lower your dose or take you off the drug gradually in order to try another drug. It’s important not to suddenly stop taking Keppra, as your seizures may become worse. Approximately one in 60 adults taking Keppra stop because of the side effects.

Keppra is not the only anti-seizure drug associated with behavioral side effects. Behavioral side effects are common in anti-seizure medications because they are making chemical changes in the same parts of your brain responsible for mood and emotion.

According to the Epilepsy Foundation, Sabril, Gabitril, Zonegran, phenobarbital and Mysoline can also increase symptoms of depression. Neurontin and Zonegran can also increase irritability, and Felbatol can also increase anxiety.

Keppra is approved by the FDA to control seizure in adults, children and infants one month or older. It works by stabilizing abnormal electrical activity in the brain.

Keppra is used to treat epilepsy and seizure disorders, including:

  • Adult and juvenile myoclonic epilepsy
  • Temporal lobe epilepsy
  • Focal impaired awareness or complex partial seizures
  • Myoclonic Seizures
  • Secondarily generalized seizures or bilateral tonic-clonic seizures
  • Focal aware onset seizures
  • Tonic-clonic seizures

Keppra is not recommended for people who have had depression, or are pregnant or planning to be pregnant.

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