My daughter almost 4 was on Keppra also. It definaly has moody side effects. I would keep it on the lowest possible dose if there is not another drug to choose from. You can always try it to see the effects on your son. Not every chid will react the same way. We were able to take her off that med because her seizure activity got alot better.

Hello,

Your situation is a very difficult one.  First, I have to say that the AED's will effect people differently. I do not mean to say that this will happen to you because your child may respond wonderfully to keppra.

Two of my children have Asperger's disorder and were taking keppra for seizure control.   My son was exhibiting impulsive behavior which I thought was either a consequense of the seizure disorder or Asperger's disorder.  After 3 years of use we took him off of it when he was 8 years old and saw improvement in his impulsivity. 

 The 5 year old was also taking keppra but the behaviors were much worse.  Impulsivity, agression, running away from school and violent outbursts.  After 1 year on keppra we took her off and her symptoms also improved.

My concern after talking with many parents is that keppra will worsen the symptoms in some children who have developmental disorders and other disablities.

 However, I take keppra with carbatrol and it has improved my quality of life and seizure control.  Not to say that I do not have psychiatric symptoms from time to time, because this is common in partial epilepsy.

Your situation is a unique one and I would approach it with caution.  Since your child is only 3.5 yrs old,  it may be difficult to differentiate between behaviors due to the ADHD, epilepsy or AED.   As children get older, more demands are put on them in school, the enviroment changes and socialization becomes more difficult and they will react to these changes in different ways, some of which can be maladaptive.  Are the reactions due to the drug?  In most cases it is impossible to tell.

Would it be possible to have the testing done before your child is put on keppra?  Also, given the fact that your child has epilepsy,  it is prudent to have a neuropsychologist do an evaluation.  Most school psychologists have limited experience dealing with epilepsy and are not familiar with the psychiatric and learning problems associated with it. 

Since I am not familiar with ADHD, I am not sure of what you should look out for when your child is put on keppra. Obviously, any behaviors that are dangerous or out of character should be reported to the neuro immeditely.  I would also watch for worsening of the ADHD symptoms.

Good luck.  I hope all goes well. 

Hi CC Ann,

My daughter, Missy, is 3.5 yrs old and has been on Keppra for about 1.5 yrs with no signs of psychotic behavior.  I would be patient with your son. Let the preschool psychologist evaluate him for ADHD and find out the results.  In the meantime, don't let the doctors warning about psychotic behavior worry you.  If, after your son has been on keppra for more than a couple of weeks, you begin to notice him being more aggressive than you have seen previously, then I would bring up the behavior concern to your doctor as soon as possible.  I would also let the preschool psychologist know about beginning him on keppra, so that they are aware of the situation. 

Also, I hope that you are weaning your son off of the zonegran.  I say this because if your son has been on zonegran (or any med) for more than a week or two, it is wise to slowly transition your child off of the med.  If you take your son off of the med cold turkey or too quickly, it could actually cause withdrawal symptoms. I understand how hard it can be getting the meds to work just right.  Missy started out on topamax at 2.5 months old.  She has since been on topamax with keppra, weaned off the topamax, and had klonopin and zonegran added to her keppra to help control her seizures.  The keppra has helped control her partial seizures, however could not control her myoclonic (startle) seizures on its own.  The klonopin and zonegran have helped bring down the number of myoclonic seizures she has each day.  We are still working on getting Missy seizure-free and may have to start looking at other options (such as VNS).  However, we are staying hopeful that her seizures will come under control.

I hope that all goes well for your son and your family.  Keep logs of his seizures and any behavior changes.  And above all else, remember that he is your son and to follow your gut.  Good luck and God bless.

Missy's Mom