Tired: Seizures vs. Medication vs. Depression

I'm currently taking Keppra 500mg twice daily for epilepsy and am also on Lexapro 20mg at bedtime for depression.  I am literally exhausted and unmotivated all day, every day.  I'm so fatigued, I just want to sleep constantly.  The Lexapro does not seem to be helping the depression issues.  And being on the Keppra has only made me feel more tired and unmotivated.

My primary had put me on Wellbutrin which caused me to have a grand mal seizure (I have absence seizures typically).  Now I have to be on Keppra to prevent another grand mal seizure so that I can get my driver's license back.  Meanwhile, I'm off the Wellbutrin and have switched primary care physicians.  My new primary care doc has me on a low dose of Lexapro.

I'm just so tired of being tired all of the time.  My doc insists my bloodwork is normal.  My neurologist insists the Keppra is the right drug.  My husband's patience is wearing thin with seeing his wife sleep all of the time and sit on the couch all day long.

Has anyone else dealt with anti-depressant and anti-convulsant med therapy?







Re: Tired: Seizures vs. Medication vs. Depression

sounds quite familiar.  i added lexapro three months ago to keppra and others and it seems to have helped with my mood, but decreased my energy.  i notice a difference on days when i have to do things: volunteering, appointments,.... these days i seem to have more motivation. i am happy for the better mood, but need to fix the energy. maybe i can find some mandatory tasks to reengerize myself early in the morning almost every day. i hope i get around to setting them up. maybe a yoga class?

Re: Tired: Seizures vs. Medication vs. Depression

How long have you been on the Keppra?  If it has only been a short amount of time (like 3-8 weeks) you have to give it time for these side effects to wear off.  As with any new drug, it takes a little while for the body to get used to. 

However, if it has been longer (like over 4-5 months), if it were me, I would talk to your neuro about the options of switching medications, sure, it may be controlling your seizures, but you have to think about your quality of life too!!  A lot of people have depression, rage, a moodiness as a side effect with Keppra, not to mention the frequent need to sleep.  There are other meds out there, Topamax, Lamictal, Tegretol, etc (just to name a few)...explain to your neuro that you are not happy, if your neuro disagrees, get a new neuro who is willing to work with you, after all its your life we're talking about!!! You should not have to suffer this bad, there may be an AED that can help you with less harsh side effects.  

Explain to your husband what's going on, explain how the med's side effects make you feel, schedule the doct. appt. together, write a list of your symptoms together, go to the appointment together, both of you address your concerns up front and honestly to your neuro.  Keep your husband in the loop, don't shut him out. (that was a huge problem for me).  At that point, maybe you will feel a little better and will have reached some resolution.  

Its hard and scary sometimes and its hard to tell if the depression just comes from the seizures and having E. or is it a side effect of the AED's.  I know I have bad days when I just want to crawl up in a ball and hide away from the world just from sheer anxiety, but its really better to just get out there, eat right, exercise, and to do things that I love to do (that are within a healthy capacity), etc....even though the thought of doing so sometimes makes my skin crawl.   Believe me its good for your brain chemistry (it keeps your endorphins going).

Hang in there, it will get better!

Re: Tired: Seizures vs. Medication vs. Depression

I've been on the Keppra since February - so 3 months.  The fatigue is better than it was in the beginning, but it still really interferes with daily life.

My husband and I are going to see my primary care physician and neurologist together.  He's been really supportive.  But it's hard for him to understand why I don't feel like moving and why I am so tired I just want to sleep all of the time.

Re: Tired: Seizures vs. Medication vs. Depression

Hi there-

 I have been on dilantin for 12 years and also take a small dose of lexapro(5mg).. I take it in the morning and agree with you, it makes me very sleepy too...  I take it for anxiety and it controls it at such a small dose, so I dont want to stop taking it!  Do you get any exercise at all?  I feel that helps me.  What about taking the lexapro in the morning?  How long have you been on the lexapro?  I didnt notice any changes until 4 weeks or so..

Re: Tired: Seizures vs. Medication vs. Depression

I don't currently exercise.  I'm so tired, I literally feel like it's a chore to get up off the couch most days.

Re: Tired: Seizures vs. Medication vs. Depression

 "I'm just so tired of being tired all of the time.  My doc insists my bloodwork is normal.  My neurologist insists the Keppra is the right drug.  My husband's patience is wearing thin with seeing his wife sleep all of the time and sit on the couch all day long"......same here. I'm taking keppra (XR, 750mg, 2 a day)and they said the same thing to me. We are also on the same dose of Lexapro and there have been times that I didn't take it because it didn't seem to make a difference- but I was very wrong. Now I don't miss a does.  I have been on several anti-depressants/anti-anxiety drugs and Lexapro has been best for my mind. I do wish it worked better though.    I have a question for you- Do you have memory problems. Severe problems? I do. I have about 15 or more "shivver seizures" a day....can't think of what neuro called them along with absence. I know that is part of making me tired almost all day; and they seiz. caused memory to go horrible because they are so frequent...but I think some of one of those meds is also contributing to these problems.  The tiredness is one thing that is awfull, but my memory is embarassing and depressing. In a way I hope you say you have memory problems too because since we take the same meds it could be one of those causing extra memory problems.  Hope I helped you and maybe you can help me. Good luck


Re: Tired: Seizures vs. Medication vs. Depression

Dear Karries,

My daughter is 21 now, but when she was 16, a pretty major depression hit her.  All of a sudden, she couldn't get out of bed in the morning for school..She also had some anxiety attacks.  She missed a lot of school. She had been on tegretol prior to keppra, for several years, but it was wearing off, she started having seizures.   I thought the depression was caused by the keppra and told the doctor that.  He said he didn't think so, and advised she see a counselor.  After seeing several doctors, and getting nowhere, we switched to an epilepsy specialist, took her off the keppra and the depression lifted.  But I remember the extreme fatigue she had and thought you would want to know about this.  Now Christina is on lamictal and onfi. Onfi has also caused depression, fatigue, intrusive thoughts and some other issues.  We're going to take her off the onfi, but again, it has taken quite some time to get the dr to see that this medicine is no good for her.   I say go with your gut feeling.  Its mostly trial and error and the doctors just seem to think a solution is to add more drugs.  Christina is on Lexapro,(anti depressant) but think she will be able to drop that, once the onfi is stopped.  Godd luck to you , it can all be very trying, I know.

Re: Tired: Seizures vs. Medication vs. Depression

Yes, I've been on all three of those meds one time or another. Keppra did absolutely nothing for my seizures but mine are non epileptic.

But, I can offer some advice on anti depressant meds. I've tried Celexa, Lexapro, Welbutrin, and Cymbalta. So far, cymbalta has done wonders for me. It has the least amount of side effects in my opinion. I was on the Lexapro for almost 2 years and it just stopped working for me. It no longer helped with the depression and it seemed like all they were doing is upping the dosage. Finding the right drug for depression can make the depression worse and it is very frustrating. Trial and error is the only way, even though I know that sucks. Hang in there, and I truly wish you the best. Let me know if there is anything I can do.

Re: Tired: Seizures vs. Medication vs. Depression

i am going throug the same thing i always say im tired of being tired ,ihave atonic seizures and simple partial seizures ,am on depakene 500 once aday along with apetryl 0,5mg at night also iam taking no deprine for depression iam just like you always tired and exhausted and always want to sleep but the defference is i have two children and they  need  all the attintion and energy so iam always in fight with fatigue and pain .god bless you

Re: Tired: Seizures vs. Medication vs. Depression

M 18 year old daughter is on Lamictal - 300 mg x2 a day, Topamax - 100 mg x2 a day, and within the past two weeks the drs. added Depakote - ER 250 mg once a day for now and Lexapro 10mg x1 a day.  Her seizures (tonic-clonic) were under control for about a year, then she has had 4 since July, 2 in November.  But since she has started depakote and Lexapro (both about two weeks ago), she is VERY tired.  Had to take her to the ER this morning because she was VERY dizzy and could not walk, speech was slurred.  After some blood tests, the ER dr. told me to stop the Lexapro??  He thought that was cuasing the extreme dizziness.  Has anyone had anything similar or a similar combination of drugs?  thanks. dpace

Re: Tired: Seizures vs. Medication vs. Depression

Depakote made me extremely tired.... zombie like

Re: Tired: Seizures vs. Medication vs. Depression

I have all of these concerns and more.

Fatigue: My PC (granted, he is not a neuro)told me that most AEDs are made to suppress the excess electrical activity is the brain. The side effect is that they can suppress the kind of electrical activity we need.This causes the brain activity we DO want to diminish a little. Hence, this causes depression, fatigue, etc. Epilepsy itself causes some of this, too. There isn't much we can do about it.

Sleep: Sleep is supposedly an issue for a lot of people- including me. I cannot get to sleep at night and rarely enter REM sleep when I do sleep. Then, during the day, I can hardly function because I am so tired. I have had somewhat decent results from Ambien CR at night and Nuvigil in the AM. Lunesta was a disaster for me. Each person will react differently to each drug.

Memory: I looked through another post where people were talking about memory devices. Keep a small note pad in your pocket or purse, along with a pen, to write down anything you want to remember. One member used Post-It notes all around the house (on the coffeemaker, front door, in the bedroom and bathroom, etc to remember. These are all very brilliant ideas. I keep a favorite book on the near end of my book case with computer passwords between the pages, or use the names of my favorite books, movies, etc as passwords. Make sure to write down the most current ones and keep them current.

Depression: That's a tough one. Just keep trying various things.I have been told that Cymbalta works well, though I don't know that for a fact. Each person is different, too. I know to stay away from Welbutrin. It's clinically proven to cause sezires, even in 'normal' people.

These issues are a fact of life for us and there is not much we can do but work around it and try different things. Each of us is different, though. I hope my comment is useful, only if for one person. Love to all of you.

Re: Tired: Seizures vs. Medication vs. Depression


Perhaps you could ask the doctor if a time-release medication could be prescribed, if you are not taking one now, so that side-effects could be minimised through gradual elimination of the drug throughout the day It might give you a constant supply throughout the day and because of the gradual release of medication to your bloodstream, the side-effects may be minimised as compared to having severe side effects at peak efficiency sooner with a drug that is  released all at once and needs to be constantly repleneshed to maintain its anticonvulsant or antidepressant effect. I think a time realease option may be better to give you the least amount of medciation needed with the fewest side-effects. Hope this helps. 

Re: Tired: Seizures vs. Medication vs. Depression

yes I take my meds ( when I remember to ) I have a serious trust issue which doesn't help with depression. Feelings of others about who are speaking about a topic often makes me uncomfortable because I feel it's aimed my way. What's the word? Schizophrenic. I just try to ignore these feelings as I am pretty sure it doesn't all pertain to me. I've been told I tend to overthink about things I shouldn't have to. Bottom line is Yes,I take AEDs and Yes I get depressed. Is the Paranoia just in my head ?
Maybe I am just thinking about it too much. I'll roll that idea inside of my head for awhile. (:

Re: Tired: Seizures vs. Medication vs. Depression

I had the same problems as you had before. I used to be taking 2000mg of keppra a day, but I'd still get the occasional seizure here and there. I never got on antidepressants because I never told my doctor (or anyone) about the depression.

Anyway, one suicide attempt later, my doctor recommended (on the hush hush) that I try cannabis and that it would help better than the pills I was on. He also told me that the pills I was on were causing the depression/mood swings/suicidal thoughts/aggressive behavior. If I'd told him he would have taken me off those pills immediately. Ever since I started, I halved my meds, and don't have any mood problems whatsoever.

It really is the healing of a nation.

Re: Tired: Seizures vs. Medication vs. Depression


I'm also on Keppra, and i have to say it does make me very tired sometimes, iv noticed a significant drop in my energy levels. However, when i started the keppra last year i was warned that it can cause depression and even suicidal feelings, i was also told that if this happened i should tell my doctor or specialist and would be taken of it immediately. Keppra is a very good drug for some people but like all drugs it doesnt work for everyone, your doctor shouldn't be keeping you on medication thats causing mental harm because thats what its doing, its keeping you depressed which in turn is putting ur epilespy out of control. You could speak to your doctor or specialist again, if they insist that you stay on keppra request a transfer to a different hospital or even just a different specialist. Your chemist may be able to help in the mean time, or if you have a specialist nurse department within your hospital, it may be known as an epilepsy clinic, they can be very helpful and influencial. 

Good Luck!

Rebecca x