Levetiracetam — sold as Keppra, Elepsia, and Spritam — is often prescribed to help manage epilepsy. Some people who take this drug wonder which beverages they can safely drink alongside this medication. In fact, this is a frequent question and concern for members of MyEpilepsyTeam.

“I know alcohol messes with medications, but does Red Bull or any energy drink have an effect on seizure medication?” a member asked.

Another member noted: “I’ve noticed since I’ve been drinking these energy drinks … that it’s made me very dehydrated and I’ve had an increase in seizure activity.”

Here’s what you need to know about drinks that may interact with levetiracetam. You’ll also learn when to talk to your doctor about your anti-seizure medication.

Drinks To Avoid While Taking Levetiracetam

Levetiracetam is an anti-seizure medication that comes in tablets, an oral solution, or intravenous (IV) solution. It’s designed to slow down or calm overactive electrical signals in your brain, which can help with seizure control.

You may wonder whether caffeinated drinks can impact its effectiveness. Most health experts note that drinking normal amounts of caffeine doesn’t appear to affect seizure control. But drinking it in large amounts could disrupt your sleep.

That said, everyone experiences epilepsy differently. While caffeine may be fine for some, others may find large amounts are a seizure trigger. The exact amount of caffeine that causes disruptive effects can vary in each person. If caffeine affects the number and frequency of your seizures or your sleep, you may want to make some changes.

Energy Drinks

Energy drinks such as Red Bull, Monster, 5-hour Energy, and Rockstar are marketed as a way to boost your physical and mental performance. But these drinks can be harmful if you aren’t careful about how much you consume.

For instance, some energy drinks may contain high amounts of caffeine. In extremely high doses, caffeine can cause:

Insomnia (inability to sleep) can also be a side effect of energy drinks. This can, in turn, lead to tiredness and drowsiness, which are strongly linked with triggering a seizure. Side effects of overdosing on caffeine can even be severe enough to require a trip to the hospital.

Tracking Caffeine Levels

Energy drinks aren’t the only products with high levels of caffeine. The U.S. Food and Drug Administration (FDA) says caffeine amounts can vary depending on the product and its serving size. In fact, FDA data shows caffeine ranges can sometimes even overlap with brewed coffee.

It’s important to know how much caffeine you consume in your drinks and in the products you eat. This is the only way to know for sure if you’re consuming a “normal” amount of caffeine each day. For most adults, 400 milligrams is considered an appropriate amount of caffeine a day.

But this amount may need to be lower for some people. If you’re sensitive to caffeine’s effects, you may want to limit your consumption or avoid it completely.

What Research Says About Energy Drinks and Seizures

There may be a connection between energy drinks and seizures. But researchers haven’t proven that these beverages can cause seizures. That said, a 2014 study showed that children and adolescents are at greater risk for post-energy drink seizures.

These beverages can also cause a rapid heart rate, heart palpitations, digestive issues, anxiety, sleep issues, and dehydration in kids. Because of these risks, the American Academy of Pediatrics indicates that kids and teens shouldn’t consume energy drinks.

Other Beverages

Caffeine from other sources, including caffeine shots and pills, coffee, soda, and tea, can also affect you.

One member of MyEpilepsyTeam said, “I don’t touch energy drinks or anything with caffeine because they’ll create triggers, which lead to seizures, especially with Keppra. Energy drinks will do twice the damage that coffee will do because of two to three times the caffeine.”

Alcohol

There’s no evidence that alcohol can reduce the effectiveness of levetiracetam. But drinking alcohol can lower seizure threshold, worsen sedation, and cause withdrawal seizures.

Typically, moderate-to-heavy drinking isn’t a good idea either, especially when you have epilepsy. If you drink alcohol regularly, discuss your personal risks with your healthcare provider.

Alternatives

You may want to track how much caffeine you drink daily. Then you can try to stay within the daily recommended limits.

You could also try other options like green tea, decaffeinated coffee, and caffeine-free sodas. But remember that green tea and even decaffeinated beverages still contain caffeine.

Another option is to increase how much water you drink daily. Water helps hydrate you and also has other benefits, including lubricating your joints, maintaining your body temperature, and promoting bowel movements.

If you find you need an energy boost most days, consider making dietary changes instead of grabbing an energy drink. Eating a balanced diet high in protein may help you maintain good energy levels, whether you’re living with epilepsy or not.

Medications To Avoid While Taking Levetiracetam

If you’ve been prescribed levetiracetam, take it exactly as prescribed by your healthcare provider. Also let your doctor know about any other medications or supplements you’re taking.

Sometimes supplements or other drugs can interact with levetiracetam. In other cases, these drugs may be fine to take as long as the doses are adjusted or other precautions are taken.

Medications To Avoid if Possible

Medications that aren’t usually recommended to be used alongside levetiracetam include:

If you’ve been prescribed one or more of these drugs alongside levetiracetam, talk to your healthcare team. They may change the dosages or advise you to change the frequency of one or both medications. Do not stop any prescribed medications on your own.

Keep in mind, this list doesn’t include every drug that could potentially interact with levetiracetam. Make sure your healthcare provider knows everything you’re taking, even vitamins and minerals.

Also tell them if you have other health conditions like kidney disease, depression, hypertension, or a mental health condition.

Medications That May Intensify Side Effects

Certain medications and supplements can increase the side effects of levetiracetam, such as confusion, difficulty concentrating, dizziness, and drowsiness. These include: