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I take Keppra 250mg once a day. I have noticed that by 6 in the evening I get some dizzy spells. I am supposed to take 250 twice a day but I am very moody and afraid if I take more this will get worse.  Am I getting dizzy cause the medicine is wearing off or is this a side effect. I have been taking it for a year now.


I took Keppra for a little while, it made me very moody also to say the least, and my Doctors took me off of them immediately. I was also a little dizzy by time to take meds or if I was a little late. I am now on Depakote ER, Zonegran, Trilepital

I was the same way. I was very moody, no one wanted to be around me. I was dizzy aswell. The dizziness should not be because the medicine is wearing off. It, for me atleast, was a side effect of the medicine. I also stopped taking Keppra and now take Lamictal. It has made my life much easier. 

Well, if you have been prescribed to take 250 mg of Keppra twice a day, then maybe that's what you need to be doing. When a person with epilepsy has been prescribed to take their antiepileptic medication, that was prescribed by their doctor, then you take the medication however many times per day, each and every day. It's not a, "oh, I'll take the medication whenever I feel like it"; or, "I'll take the medication whenever I feel like I'm having seizures." If unless the doctor makes the prescription differently, the person is supposed to be taking the medication day by day, in order to maintain a steady balance of the medication inside the bloodstream. The highest dosage amount that is going to be inside the bloodstream is going to be roughly around 30 min. to an hour after the person has taken their medication. And the lowest dosage amount inside the bloodstream is roughly going to be shortly prior to when the person takes their next dosage amount of medication. For example, with you being prescribed to take 250 mg of Keppra twice a day, this would mean you should be taking your medication every 12 hours. So if you take your first daily dose at roughly 8 AM in the morning, the highest dosage amount that has been absorbed into the bloodstream should be within one hour after you took that 8 AM dosage. Then, at roughly 8 PM in the evening, you should be taking your next daily dosage amount of medication. And again, the highest dosage amount that has been absorbed into the bloodstream should be within one hour after you took that 8 PM dosage.

When treating seizure activity by antiepileptic medication, the person is trying to "Maintain" a steady flow of medication inside the bloodstream.

Here's something else that the person needs to focus their attention on. If it appears that the person is experiencing side effects from the medication, then the question is: "When are those side effects taking place?" If the side effects appear to be occurring at some point after the person has taken the next daily dosage amount of medication, then that might be an indication that the person is taking too high of a dosage amount. Next is if the person is experiencing additional seizures; "When are those seizures taking place?" If the seizures appear to be occurring at some point before the person is due to be taking their next dosage amount of medication, then that might mean that the person does not have enough medication still in their bloodstream in order to control their seizure activity. Now, if the side effects are taking place shortly after the person has taken the next dosage amount of medication; And, if seizure activity is taking place before the person is due to be taking their next dosage amount of medication, then that could be a sign that the doctor needs to make an adjustment with the prescription, by increasing how many times the patient is to be taking their medication per day. For example, if the person is taking 250 mg of Keppra twice a day, if side effects are occurring after the medication has been taken and if seizure activity is occurring prior to when the person is due to take the next dosage amount of medication, then the doctor should make an adjustment by not only lowering the dosage amount of medication, but also prescribing the patient to take the medication three times a day.

Yes, there's a whole lot more detail involving treating seizure activity by medication, that doctors are supposed to be explaining to their patients. But there's no guarantee this will always happen. Sometimes talking to a doctor might be somewhat the same as if you're talking to the wall.

Bruce (I'm not a doctor, but instead, an epilepsy support group leader, epilepsy advocate, who has epilepsy.)

XR = eXtended Release. If this isn't being taken and you are taking regular Keppra always take medicine two time a day

Hi Ckidd2000,

I utilize Keppra in an unorthodox manner too. The only medication I'm taking now is Keppra. I take Keppra mainly to prevent secondarily generalized tonic-clonics (TCs).

My TCs usually strike in the middle of about monthly clusters of strong partial seizures. To be prepared for the prodromal phase of my clusters, I take a minimal dose of Keppra before going to sleep each night. The prodromals are very vague, and not very reliable, but tend to be of some value as an earliest possible warning. By trial-and-error, and the best to minimize my prodromals to clusters of seizures, I take an alternating weaker, then stronger, minimal doses every other day before going to sleep each night. When the physical side-effects of Keppra become annoying (for me, mainly easily irritated "dry" throat and lungs), I reduce the minimal dose lower until recovery, or a distinct warning event. With a pre-ictal event, or warning, to a cluster of seizures, I take a moderate dose of Keppra immediately. My pre-ictals to a cluster of seizures is a day, to hours, before stronger seizures in a cluster before possible TCs. If, and with continuing and stronger pre-ictals and partial seizure, I then take up to a maximum dose of Keppra for the weighted time period. So far, I haven't had a notable TC for 21 months now, when they were monthly without any treatment, and just about every other month, following "professional" advice.

My seizure clusters usually reach a peak during a sleep cycle. Most research finds more than 50% of typical seizures occur during sleep cycles, the next most common, without differentiation between sleep and awake, and the least common concentrated only during complete wakefulness (the exact opposite is generally believed, because of the riddle that people are asleep when they are asleep). My non-cluster partial seizures have not responded to any medical treatment in my 58 years of life. About 35 years ago, a total carbohydrate-free diet for weight-loss/muscle-mass somewhat stopped my partial seizures, but the diet, diet expenses, and problems with bouts of hypoglycemia, tend to make the continuous diet untenable in economic practice. Bouts of painless and painful migraines, distinct from seizures, do not respond to any continuous treatment, but do respond to brief intermittent treatments, for very short periods (i.e., an isolated, occasional, dose of Keppra tends to stop my migraine, but frequent, or continuous use for TC control, neutralizes this otherwise beneficial effect of Keppra).

When a Medicaid snafu interrupted my Keppra prescriptions, I went a week without taking any Keppra. Luckily, this happened about two weeks before my period of strong seizure clusters, and rough periods of "drowsiness", "raggedy" going to sleep, and vivid dreaming were a problem, with a stronger, than other recent, clusters near schedule. I cited the "red-tape" at: epilepsy-dot-com/discussion/992143

Regular Keppra has a short half-life, so if my seizures leading to TCs were totally unpredictable, it would probably be better to take Keppra every 12 hours at large enough doses to continually block TCs. Since I can make predictions, I can reduce the frequency and the average size of doses of Keppra, and prevent needless side-effects and continual intoxication levels, while relying on how fast Keppra works when I receive a warning.

Doctors tend to be stuck with a "standard practice" philosophy. Long before my epilepsy became life-threatening with massive TCs, doctors told me that epilepsy was rare and outside of "standard practice", with my signs and symptoms. With stronger seizures, Medicaid/MediCruz dispensed haphazard doses/sources of carbamazepine and acetaminophen as "standard practice" until kidney and liver failure, then short and abrupt termination because of the 1989 Loma Prieta earthquake, because the Medicaid neurologist vanished.

Since my non-cluster partial seizures are intractable, I now follow the advice "Complete control of partial complex seizures is sometimes difficult to achieve. Since the seizure manifestations are often not too disruptive, the patient may prefer incomplete control over the side effects of high doses of medication." "Drug treatment: principles and practice of clinical pharmacology and therapeutics" by Graeme S. Avery, (1980, 1987), Chapter XXV, "Treatments of Seizure Disorders" by H. Kutt and F. H. McDowell, page 1023. This stance is beyond the understanding of many neurologists who demand a high rate of success, and/or claim nearly 100% accuracies. In fact, a doctor can't even measure something as simple as a person's height with nearly a "100%" accuracy and precision to the population's value.


I live in California, USA.


Levetiracetam is in a class of medications called anticonvulsants. It works by decreasing abnormal excitement in the brain. 

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