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Keppra and Weight Change: Is It a Side Effect?

Posted on March 26, 2024

Several antiepileptic drugs (AEDs) commonly cause weight gain or weight loss, but levetiracetam (sold under brand names including Keppra, Keppra XR, Elepsia XR, and Spritam) isn’t usually one of them. Levetiracetam is generally considered “weight-neutral,” which means that it’s unlikely to affect your weight. However, medications can affect people differently, and some people taking levetiracetam for epilepsy treatment may notice weight changes.

More than 19,000 MyEpilepsyTeam members have reported taking levetiracetam. Several members discussed their experiences with weight loss or gain. One asked, “Has anyone else experienced weight gain on Keppra? I’ve gained almost 20 pounds in just 45 days.”

Another member responded, “No, I haven’t gained any weight. Instead, it's doing the opposite. I’ve lost weight from Keppra.”

Continue reading to learn more about different ways levetiracetam might affect your weight.

What Is Levetiracetam?

Levetiracetam is an adjunctive AED (used with other medications) to treat certain types of seizures, such as:

  • Focal aware onset seizures (simple partial seizures)
  • Focal impaired awareness (complex partial seizures)
  • Juvenile myoclonic epilepsy
  • Myoclonic seizures
  • Secondarily generalized seizures (bilateral tonic-clonic seizures)
  • Temporal lobe epilepsy
  • Primary generalized tonic-clonic seizures
  • Idiopathic generalized epilepsy

Levetiracetam comes as tablets, an oral solution, or a liquid injection and in extended-release formulations. Most people are directed to take levetiracetam by mouth twice daily, about 12 hours apart.

Researchers don’t know exactly how levetiracetam works to decrease seizures. Levetiracetam is thought to change the release of certain neurotransmitters, or chemical messengers, in the brain. Levetiracetam works differently from other anti-seizure medications, which typically slow electrical signals in the brain to stop seizures caused by bursts of electrical activity.

What Are the Side Effects of Levetiracetam?

Although levetiracetam has caused both weight gain and weight loss in clinical trials, neither result is a common side effect.

The most common side effects of levetiracetam include:

  • Dizziness
  • Drowsiness
  • Fatigue
  • Headache
  • Irritability
  • Itchy or sore throat
  • Nausea or vomiting
  • Stuffy nose

Serious side effects may include:

  • Allergic reaction
  • Anger
  • Depression
  • Mood and behavior changes
  • Problems with coordination
  • Severe skin reactions
  • Suicidal thoughts or behavior

You may be more likely to experience some side effects in the first month of taking levetiracetam. Some side effects may improve as you adjust to your new medication.

How Can Levetiracetam Affect Weight?

Although levetiracetam is generally considered to be a weight-neutral antiepileptic drug, weight changes — either loss or gain — are possible while taking this drug.

In one study in the journal Epilepsy Research, almost 1,000 people took levetiracetam or a placebo (inactive substance) for epilepsy. The results showed that a small percentage of the people taking levetiracetam experienced a weight change, but it wasn’t very different from the group of people taking the placebo. The researchers concluded that levetiracetam was weight-neutral.

Levetiracetam and Weight Loss

Weight loss isn’t a common side effect of levetiracetam, but one small study focused on 19 cases of people whose weight loss was or might have been related to the treatment. The study author also cited a previous study that reported weight loss in older adults with anxiety taking levetiracetam. It’s not clear why levetiracetam may cause weight loss in some people, but the researchers think weight loss may be related to mechanisms in the body that signal hunger and fullness. Women may be at higher risk of levetiracetam-related weight loss than men, according to the researchers, but more studies are needed to discover more risk factors.

Side effects like nausea and vomiting or depression may also contribute to weight loss while taking levetiracetam.

“I lost weight when I started Keppra and then gained weight when I went off it,” wrote one MyEpilepsyTeam member. “The Keppra made food taste like nothing, so I didn’t crave food. It took a long time to balance out after taking that.”

Levetiracetam and Weight Gain

If levetiracetam causes weight changes, it’s more often associated with weight loss, not weight gain. In one small study, two of the 60 participants gained between six and 11 pounds after taking levetiracetam for three months.

If you experience depression or mood changes as a side effect of levetiracetam, you may notice more food cravings that cause you to eat more and gain weight.

“Keppra XR has been a nightmare for me,” shared a member. “I’ve gained 40-plus pounds since I started taking it back in 2004-ish.”

Epilepsy and Weight Changes

In the study that found levetiracetam was weight-neutral, 9.4 percent of people taking the placebo treatment experienced weight changes. The fact that people with epilepsy taking the placebo also experienced weight changes suggests there may be reasons other than the drug for weight gain or weight loss.

Lifestyle Factors

Lifestyle factors and other medications taken to control epilepsy can cause weight loss or weight gain. Epilepsy is most often associated with weight gain. Even though most epilepsy syndromes don’t directly cause weight gain, obesity is a common condition in people with epilepsy, according to a 2013 study in the journal Epilepsy & Behavior.

Lifestyle factors, especially lack of physical activity, can lead to weight gain in people with epilepsy. Studies have found that people with epilepsy are less physically active compared with the general population. For example, a 2006 study found that teenagers with epilepsy were less likely to participate in sports and more likely to be overweight.

Other Antiepileptic Drugs

Weight gain in epilepsy could be related to a lack of physical activity or occur as a side effect of anti-epileptic drugs, such as:

Anti-epileptic drugs that are associated with weight loss include:

Managing Weight Changes

Talk to your doctor right away if you notice that you’re gaining or losing weight while taking levetiracetam or any new medication. Your doctor may ask you to weigh yourself regularly to track any changes. Never stop taking your medication without talking to your doctor first.

If you experience significant weight changes while taking levetiracetam, your doctor can help you weigh the risks and benefits of making changes to your AEDs. They may recommend lowering your dose, switching to a different medication, or finding other ways to manage your side effects. Your doctor and a dietitian can help you learn what to eat and what to avoid while taking levetiracetam to manage weight loss or weight gain.

Physical activity is another important factor to help maintain a healthy weight. Talk to your doctor about the safest type of exercise for you.

Talk With Others Who Understand

MyEpilepsyTeam is the social network for people with epilepsy and their loved ones. On MyEpilepsyTeam, more than 120,000 members come together to ask questions, give advice, and share their stories with others who understand life with epilepsy.

Have you experienced weight gain or weight loss while taking levetiracetam? Do you have any tips on how to manage weight changes? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on March 26, 2024
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Kiran Chaudhari, M.B.B.S., M.D., Ph.D. is a specialist in pharmacology and neuroscience and is passionate about drug and device safety and pharmacovigilance. Learn more about him here.
Amanda Jacot, PharmD earned a Bachelor of Science in biology from the University of Texas at Austin in 2009 and a Doctor of Pharmacy from the University of Texas College of Pharmacy in 2014. Learn more about her here.

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