What Not To Take With Keppra: Energy Drinks, Other Drugs, and More | MyEpilepsyTeam

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What To Avoid When Taking Keppra: Energy Drinks, Other Drugs, and More

Medically reviewed by Kelsey Stalvey, PharmD
Posted on May 9, 2023

If you take levetiracetam — sold as Keppra, Elepsia, and Spritam — to help manage your epilepsy, you may want to pass on that second Red Bull or frappuccino. Though levetiracetam can effectively treat certain types of seizures, taking it along with large quantities of caffeine — as well as with alcohol and other medications — can make it less effective or even cause harmful side effects.

Levetiracetam is an anti-seizure medication that comes in a few different forms: tablet, oral solution, or intravenous (IV) solution. Most people who take levetiracetam are prescribed the oral tablet form and they take it on a schedule every day at home. The IV form is given only in the hospital.

Members of MyEpilepsyTeam who take levetiracetam sometimes ask about how their epilepsy medication might interact with their favorite beverages. “I know alcohol messes with medications, but since when do people say Red Bull or any energy drink has an effect on seizure medication?” a member asked.

Another member described a seizure and hospitalization after consuming an energy drink. “I’ve noticed since I've been drinking these energy drinks, preferably Red Bull, Amp, Rockstar, or Monster … that it's made me very dehydrated and I've had an increase of seizure activity … which ended up putting me into the hospital.”

Read on to learn about drinks that can interact with formulations of levetiracetam, what drink alternatives are available, and when to talk to your doctor about your anti-seizure medication.

Drinks To Avoid While Taking Levetiracetam

Certain drinks can increase your risk of having a seizure. These include beverages containing caffeine, sugar, and alcohol.

Energy Drinks

The makers of energy drinks such as Red Bull, Monster, 5-Hour Energy, and Rockstar market these beverages as an effective way to boost your physical and mental performance. However, these drinks aren’t regulated by the U.S. Food and Drug Administration (FDA), and they can be harmful if you’re not careful about how much you consume.

Energy drinks can be dangerous for anyone because they contain high amounts of caffeine, which is a stimulant. The amount of caffeine within an energy drink is usually substantially higher than what’s in a regular cup of coffee or can of soda.

Research has found that energy drinks can trigger seizures, even in people with no history of seizures. A 2014 study showed that children and adolescents are at particular risk for seizures from consuming energy drinks. Dehydration –– a known side effect of energy drinks –– can also lead to seizure.

Notably, some researchers believe that it’s not the stimulant itself that increases a perons’ risk of seizure. Rather, it’s the energy “crash” that happens after it wears off.

Additionally, research involving rats has found that high doses of caffeine may interfere with levetiracetam’s anticonvulsant action — that is, its ability to control seizures. More research is needed, though, to see whether the same holds true for humans.

High doses of caffeine can also cause:

  • Tremor
  • Agitation
  • Heart rhythm abnormalities
  • Heart palpitations (e.g., rapid fluttering heartbeat)
  • High blood pressure
  • Breathing difficulties
  • Lightheadedness

Additionally, insomnia (an inability to sleep) can be a side effect of energy drinks. Tiredness or drowsiness is strongly linked with triggering a seizure.

Side effects of overdosing on caffeine can be severe enough to sometimes require a trip to the hospital.

Energy drinks often contain other ingredients that can affect your brain when consumed in high quantities, such as sweeteners, amino acids, guarana, and taurine.

Other Caffeinated Beverages

Caffeine from other sources, including caffeine shots and pills, coffee, soda, and tea, can also impact your seizure risk — especially if you have a low seizure threshold.

One member of MyEpilepsyTeam said “No. I don’t touch energy drinks or anything with caffeine because they will 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.”

Alternatives to Caffeinated Drinks

In general, it’s safest for people who experience seizures to stay away from energy drinks and other beverages that contain high amounts of caffeine. Staying away from beverages with high amounts of sugar is also a good idea to prevent energy crashes. Be sure to drink plenty of water, given that caffeine and sugar can be dehydrating.

Tea, especially green tea, is a good alternative to highly caffeinated energy drinks when consumed in moderation. Decaffeinated coffee, teas, and sodas can also work well.

Instead of relying on caffeine and other stimulants for energy boosts, consider making some dietary changes. Eating a balanced diet high in protein is important for maintaining good energy levels, whether you’re living with epilepsy or not.

Alcohol

Moderate to large amounts of alcohol can also adversely interact with anti-seizure medication, making you feel intoxicated more quickly and lowering your seizure threshold. Alcohol withdrawal can also cause seizures and be life-threatening.

Mixing energy drinks and alcohol — which is a popular trend — can be even riskier than drinking alcohol by itself. One study used a medication to induce seizures in animals and compared the seizure onset time for those given an energy and alcohol to those who weren’t. The seizure onset time was significantly shorter in the energy drink and alcohol group.

Health experts advise that people who are taking anti-seizure medication avoid consuming alcohol. Like caffeine, drinking excessive amounts of alcohol can trigger seizures in people who’ve never had one before.

Medications To Avoid While Taking Levetiracetam

Several medications can interact with levetiracetam and cause serious health problems. In some cases, two medications should never be used together. In other cases, they can be as long as the doses are adjusted or other appropriate precautions are taken.

Medications and supplements that may have undesirable interactions with levetiracetam include:

  • Methotrexate
  • Orlistat
  • Calcifediol
  • Gingko
  • Other anti-seizure medications, including carbamazepine and benzodiazepines
  • Antihistamines (i.e, allergy medications)
  • Antidepressants
  • Antipsychotics
  • Cannabis
  • Clonidine
  • General anesthesia medications
  • Anticoagulants
  • Opioids

This list does not include every medication that interacts with levetiracetam. If you are unsure about a medication, a new beverage, or a new food, it is always advised to seek professional medical advice. Note, too, that some drugs and medications can increase your risk of seizures.

Talk to Your Doctor

When taking any medication –– but especially an anti-seizure medication –– it’s important to follow the directions, dosing, and schedule directly as prescribed by your neurologist. A lot of different substances can have drug interactions, and it’s important to make sure you’re not accidentally increasing your risk for a seizure while taking Keppra.

Sometimes, even things we don't think of can interact with medications. Herbs, supplements, and natural remedies can sometimes seriously affect the medications you’re taking or your risk of having a seizure. Be sure to talk with your doctor before adding anything new to your diet — including energy drinks.

Talk With Others Who Understand

MyEpilepsyTeam is the social network for people living with epilepsy and their loved ones. On MyEpilepsyTeam, more than 114,000 members come together to ask questions, give advice, and share their stories with others who understand life with epilepsy.

Are you taking levetiracetam for epilepsy and wondering about the risks of energy drinks? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on May 9, 2023
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Kelsey Stalvey, PharmD received her Doctor of Pharmacy from Pacific University School of Pharmacy in Portland, Oregon, and went on to complete a one-year postgraduate residency at Sarasota Memorial Hospital in Sarasota, Florida. Learn more about her here.
Remi A. Kessler, M.D. is affiliated with the Medical University of South Carolina and Cleveland Clinic. Learn more about her here.

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