What is Keppra?
Doctors prescribe Keppra for people who have certain types of seizures. People might abuse this medication to achieve the sedating effects it can produce. Some people also abuse the drug for the dizziness that can occur. Abusing Keppra can cause a variety of dangers. One of the biggest issues that people may face is what happens when they abruptly stop taking it without a medically-supervised Keppra detox. A tapered approach is recommended when getting off of Keppra.
Signs, Symptoms and Laboratory Findings of Acute Overdosage in Humans
The highest known dose of Keppra received in the clinical development program was 6000 mg/day. Other than drowsiness, there were no adverse reactions in the few known cases of overdose in clinical trials. Cases of somnolence, agitation, aggression, depressed level of consciousness, respiratory depression, and coma were observed with Keppra overdoses in postmarketing use.
Management of Keppra Overdose
There is no specific antidote for overdose with Keppra. If indicated, elimination of unabsorbed drugs should be attempted by emesis or gastric lavage; usual precautions should be observed to maintain the airway. General supportive care of the patient is indicated including monitoring of vital signs and observation of the patient’s clinical status. A Certified Poison Control Center should be contacted for up-to-date information on the management of overdose with Keppra.
Standard hemodialysis procedures result in significant clearance of levetiracetam (approximately 50% in 4 hours) and should be considered in cases of overdose. Although hemodialysis has not been performed in the few known cases of overdose, it may be indicated by the patient’s clinical state or in patients with significant renal impairment.
Keppra Detox & Withdrawal Timeline
There is no official withdrawal timeline for Keppra. Doctors caution that people should not stop taking Keppra without their approval. It is important to be weaned from this medication to reduce the risk of seizures.
The time period in which a person should be weaned from Keppra depends on the dose they take and how long they have been taking the drug. There are no specific guidelines for how a person should be weaned off and how long this should take. The tapering schedule will be designed by the supervising physician for the individual case.
The general recommendation for anticonvulsant medication tapering is one to three months. The doctor determines how much to lower the dose and at what frequency. People should not attempt to taper themselves off of Keppra on their own. This is especially important if the person has a history of seizures. A medical Keppra detox may be needed in these cases.
Keppra Detox & Symptoms of Withdrawal
One of the biggest concerns with Keppra withdrawal is experiencing a seizure. Due to the risk of seizure, a person who is withdrawing from Keppra should be continuously monitored by people who know how to assist if a seizure occurs during Keppra detox. Here are a few of the withdrawal symptoms in which to be aware:
- Nasal congestion
- Decreased appetite
- Becoming aggressive
Can Medications Be Used During Keppra Detox & Withdrawal?
There are no medications used during Keppra withdrawal except Keppra itself on a tapering schedule. The guidelines associated with this are designed for people who take the medication as prescribed for seizures. A review of the literature that looked at 25 randomized controlled trials found no taper guidelines.
However, many of the studies involved in this literature review looked at a gradual taper protocol. In these trials, the protocol ranges from one month to over four years. However, there was no mention of medications except the anticonvulsant medication the person was taking. When someone experiences a seizure, it is important to keep them safe. In some cases, health care staff may use a rescue treatment for acute seizures that are a result of withdrawal. These medicines work quickly to slow down activity in the central nervous system to stop a seizure.
Medicines that might be used for an acute seizure include benzodiazepines, such as lorazepam, diazepam, or midazolam. If a person is still able to take a pill, they might be given orally. There are also sprays, buccal, injectable, and sublingual options for those who are unable to swallow a pill.
Depending on the severity of the seizure, additional support may be necessary to stabilize the person, such as monitoring their blood pressure and providing assistance with their airway and oxygenation.
What is the Keppra Detox Process Like?
Keppra detox varies for everyone. It will depend on how long the person was taking Keppra, how often they took it, and their dosage levels. The doctor or addiction treatment specialist will evaluate the person’s Keppra use and give more information on what they might expect during this process. It is best to go to a detox center such as We Level Up California, especially if someone abused this drug at high doses for an extended time. This ensures that if a seizure does happen during the process, the person can receive immediate attention.
Keppra Warnings and Precautions
Behavioral Abnormalities and Psychotic Symptoms
Keppra may cause behavioral abnormalities and psychotic symptoms. Patients treated with Keppra should be monitored for psychiatric signs and symptoms.
In clinical studies, 13% of adult Keppra-treated patients and 38% of pediatric Keppra-treated patients (4 to 16 years of age) compared to 6% and 19% of adult and pediatric placebo-treated patients, experienced non-psychotic behavioral symptoms (reported as aggression, agitation, anger, anxiety, apathy, depersonalization, depression, emotional lability, hostility, hyperkinesias, irritability, nervousness, neurosis, and personality disorder).
A randomized double-blind, placebo-controlled study was performed to assess the neurocognitive and behavioral effects of Keppra as adjunctive therapy in pediatric patients (4 to 16 years of age). The results from an exploratory analysis indicated a worsening in Keppra-treated patients on aggressive behavior (one of eight behavior dimensions) as measured in a standardized and systematic way using a validated instrument, the Achenbach Child Behavior Checklist (CBCL/6-18).
In clinical studies, 1% of Keppra-treated adult patients, 2% of Keppra-treated pediatric patients 4 to 16 years of age, and 17% of Keppra-treated pediatric patients 1 month to <4 years of age experienced psychotic symptoms, compared to 0.2%, 2%, and 5% in the corresponding age groups treated with placebo. In a controlled study that assessed the neurocognitive and behavioral effects of Keppra in pediatric patients 4 to 16 years of age, 1.6% of Keppra-treated patients experienced paranoia, compared to 0% of placebo-treated patients. In the same study, 3.1% of Keppra-treated patients experienced a confusional state, compared to 0% of placebo-treated patients.
Suicidal Behavior and Ideation due to Keppra Consumption
Antiepileptic drugs (AEDs), including Keppra, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Patients treated with any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.
Pooled analyses of 199 placebo-controlled clinical trials (mono- and adjunctive therapy) of 11 different AEDs showed that patients randomized to one of the AEDs had approximately twice the risk (adjusted Relative Risk 1.8, 95% CI:1.2, 2.7) of suicidal thinking or behavior compared to patients randomized to placebo. In these trials, which had a median treatment duration of 12 weeks, the estimated incidence rate of suicidal behavior or ideation among 27,863 AED-treated patients was 0.43%, compared to 0.24% among 16,029 placebo-treated patients, representing an increase of approximately one case of suicidal thinking or behavior for every 530 patients treated.
There were four suicides in drug-treated patients in the trials and none in placebo-treated patients, but the number is too small to allow any conclusion about drug effect on suicide.
The increased risk of suicidal thoughts or behavior with AEDs was observed as early as one week after starting drug treatment with AEDs and persisted for the duration of treatment assessed. Because most trials included in the analysis did not extend beyond 24 weeks, the risk of suicidal thoughts or behavior beyond 24 weeks could not be assessed.
The risk of suicidal thoughts or behavior was generally consistent among drugs in the data analyzed. The finding of increased risk with AEDs of varying mechanisms of action and across a range of indications suggests that the risk applies to all AEDs used for any indication. The risk did not vary substantially by age (5-100 years) in the clinical trials analyzed. Table 2 shows absolute and relative risk by indication for all evaluated AEDs.
What To Look For in a Detox Center?
Since Keppra is not a common drug of abuse, most facilities may not have experience treating withdrawal from it. Keppra may commonly be abused with other substances, so you may need to look for a center that can address polysubstance abuse.
If you have additional medical conditions, make sure the detox center is able to provide proper care for these conditions simultaneously. This is especially important for any comorbid health conditions that require daily attention, such as diabetes or heart disease. Look at reviews of the detox center to get insight into their reputation.
Choose a Keppra detox center that emphasizes comprehensive treatment. It is imperative to not only treat the Keppra abuse issue but also address any underlying circumstances that might have led to it happening in the first place. Call the center and ask about which insurance plans they take. If you don’t have insurance or the center does not accept your insurance, inquire about the total cost of treatment and if there are payment plans to use.
Reclaim Your Life With Keppra Detox
Keppra addiction is a condition that can cause major health, social and economic problems that should not be taken lightly. We Level Up California can provide you, or someone you love, the tools to recover from addiction with professional and safe Keppra detox. Feel free to call us to speak with one of our counselors. We can inform you about this condition by giving you relevant information. Our specialists know what you are going through. Please know that each call is private and confidential.
 Whitney DG, Caird MS, Hurvitz EA, Rajapakse CS, Fedak Romanowski EM. Effect of levetiracetam and oxcarbazepine on 4-year fragility fracture risk among prepubertal and pubertal children with epilepsy. Epilepsia.