Alcohol and Keppra

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Epilepsy is a chronic medical condition characterized by a history of multiple seizures. Approximately 3.4 million Americans, 1.2% of the US population, are diagnosed with a seizure disorder. The various forms of this condition can be treated through a combination of lifestyle modification, medication, or surgery.

Keppra (levetiracetam) is a drug used to treat seizure disorders caused by various factors, including alcohol use. However, if these two substances are combined against the advice of a licensed healthcare provider, the effects can be uncomfortable or downright dangerous.

Managing a chronic health issue and substance use disorder can seem frightening and impossible. If you or a loved one have been diagnosed with epilepsy and are struggling with alcohol use, Guardian Recovery has resources to aid your recovery. We offer services such as medical detox12-Step Mentoring, and individualized therapy to help you reach your sobriety and overall wellness goals.

With an individual focus, we will work with all aspects of your health, including seizures and related diseases, to ensure the best possible outcome. For information about our clinical programs or to learn more about our treatment facilities, contact us today to speak with a Treatment Advisor 24/7.

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What Is Keppra?

Keppra is a drug in a class of medications known as anticonvulsants. It can be used short term to prevent seizures resulting from certain types of stroke or traumatic brain injury. Keppra can be prescribed for long-term, daily use for people with chronic seizure disorders.

Keppra May Treat the Following Types of Seizures:

  • Partial-onset – Seizures affecting only one part of the brain, commonly with minimal muscle involvement and rare changes in level of awareness.
  • Generalized tonic-clonic (grand mal) – Seizures involving spontaneous electrical activity in multiple portions of the brain, characterized by muscle contractions and loss of consciousness.
  • Juvenile myoclonic – A form of epilepsy characterized by rapid and uncontrolled muscle jerks beginning in childhood or early adolescence.

It is common for people with partial-onset or juvenile myoclonic seizure disorders to progress to a more severe tonic-clonic form of epilepsy later in life. Keppra may be used as a primary medication to treat the condition or added to another medication regimen to control seizure activity better.

The way Keppra works to prevent seizures remains unknown. However, some research suggests it regulates certain brain chemicals to prevent uncontrollable electrical activity. It is typically taken multiple times a day, with effects on seizure activity beginning after the first dose.

Common Side Effects of Keppra Include:

  • Dizziness.
  • Weakness.
  • Fatigue.
  • Trouble maintaining balance or walking.
  • Confusion.
  • Irritability or aggression.
  • Headache.
  • Changes to appetite.
  • Nausea, vomiting, constipation, or diarrhea.
  • Neck or joint pain.
  • Vision changes.

Alcohol interacts with most prescription and over-the-counter medications to some extent. Not only does it alter how your body breaks down and utilizes medications, but those drugs also impact how well your system can metabolize alcohol.

Interactions between alcohol and medications are a two-way street. Many drugs are metabolized in the liver using a specific set of enzymes. Because alcohol is also broken down in the liver, the combination of drinking and prescription medication use results in higher-than-usual blood levels of both alcohol and the drug. As a result, the medication side effects may be more pronounced. Likewise, the sedative, mind-altering properties of alcohol are also enhanced. How quickly your body can metabolize either of these compounds is based on your age, body mass, and the dose or quantity of substance ingested.

Both alcohol and Keppra impact the brain’s central nervous system (CNS), meaning their sedative properties are often amplified when used simultaneously. Unlike other anticonvulsants, Keppra is only minimally processed in the liver, making it an excellent choice to treat seizure disorders for people who use alcohol in moderation. However, it will lose some benefits if you drink more than one to two alcoholic beverages daily.

Keppra for Alcohol Withdrawal Symptoms & Detox

Keppra can prevent withdrawal seizures in people detoxing from moderate-to-severe, chronic alcohol use.

The effects of drinking on the brain are well-established. The CNS, consisting of the brain and spinal cord, is altered in numerous ways by intoxication. Alcohol acts as a CNS depressant, reducing brain activity that leads to loss of muscle coordination, slow breathing, decreased blood pressure and heart rate, sleepiness, delayed reaction time, and feelings of happiness and relaxation. However, these effects are short-lived unless you consume additional alcohol.

Not only does alcohol withdrawal reverse physical relaxation, but it also produces symptoms that can be physically distressing and uncomfortable. Once your body has fully broken down the alcohol in your system, the depressant effects wear off and give way to the excitatory brain activity responsible for muscle spasms, twitching, and seizures. If your alcohol use is chronic, these effects are more common and intense.

During withdrawal, hyperexcitability of the nervous system can provoke seizure activity. These neurological disturbances can cause involuntary muscle movement, behavioral changes, and variations in consciousness. They cannot be stopped by flexing muscles or forcibly holding the extremities.

Symptoms of Seizure Include:

  • Involuntary shaking.
  • Confusion.
  • Visual disturbances (aura).
  • Visual, auditory, and olfactory (smelling) hallucinations.
  • Sensation of deja vu.
  • Sweating.
  • Drooling.
  • Pale skin.
  • Emotional or behavioral changes (e.g., intense fear).

Withdrawal seizures usually begin 12 to 48 hours after the last drink. Typically seen in patients in their 40s and 50s, alcohol withdrawal seizures tend to be short-lived and limited in number, as opposed to epilepsy. They can be treated with benzodiazepines (e.g., Ativan or Valium) to activate GABA receptors and prevent intense excitatory CNS activity during the detox phase.

While limited data on the topic exists, some research suggests anticonvulsants, such as Keppra, may be used to treat mild-to-moderate alcohol withdrawal seizures alone or in combination with benzodiazepines. Left untreated, alcohol-related seizures can advance to delirium tremens, a dangerous condition with cardiovascular and neurological instability. Anticonvulsants may prevent these adverse events.

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Side Effects of Drinking on Keppra

Most reactions associated with the combination of Keppra and alcohol are intensified variations of either substance on its own. For example, while Keppra may cause drowsiness, adding alcohol would cause a much greater degree of fatigue to the point that you may be unable to function.

Common Side Effects of Combining Keppra & Alcohol Include:

  • Dizziness or feeling faint.
  • Fatigue.
  • Headaches.
  • Difficulty concentrating.
  • Mood changes.

More Serious Reactions Include:

  • Loss of balance and coordination.
  • Bruising.
  • Rash.
  • Infections.
  • Hallucinations.
  • Slow, short breaths (respiratory depression).
  • Altered consciousness.

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Managing a seizure disorder and alcohol use disorder together may seem overwhelming, but it is possible. The benefits of quitting alcohol extend beyond just physical fitness. With the proper therapeutic support and compassionate guidance, you can get the most out of your medical care and be on your way to the healthiest version of yourself.

If you or a loved one is struggling with substance use disorder, help is available 24/7 with Guardian Recovery. Contact us today to learn how our mission to offer personalized, comprehensive treatment can work for you. In addition to supplying a detailed list of services on your journey to health and wellness, we also provide a free, no-obligation health insurance benefits check. Reach out today to see how we can help.

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

  1. https://www.cdc.gov/epilepsy/data/index.html
  2. https://www.nhs.uk/conditions/epilepsy/treatment/
  3. https://medlineplus.gov/druginfo/meds/a699059.html
  4. https://www.uptodate.com/contents/levetiracetam-drug-information?search=levetiracetam-drug-&source=panel_search_result&selectedTitle=1~109&usage_type=panel&kp_tab=drug_general&display_rank=1
  5. https://www.ncbi.nlm.nih.gov/books/NBK564376/
  6. https://www.ncbi.nlm.nih.gov/books/NBK554496/
  7. https://medlineplus.gov/genetics/condition/juvenile-myoclonic-epilepsy/
  8. https://www.uptodate.com/contents/antiseizure-medications-mechanism-of-action-pharmacology-and-adverse-effects?search=levetiracetam-drug-&source=search_result&selectedTitle=2~109&usage_type=default&display_rank=1
  9. https://pubmed.ncbi.nlm.nih.gov/9260032/#:~:text=Alcohol%20can%20affect%20the%20pharmacokinetics,and%20inhibiting%20gastric%20alcohol%20dehydrogenase.
  10. https://pubs.niaaa.nih.gov/publications/aa72/aa72.htm#:~:text=Alcohol%20is%20metabolized%20by%20several,eliminate%20it%20from%20the%20body.
  11. https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-017-0532-2
  12. https://www.ncbi.nlm.nih.gov/books/NBK548785/
  13. https://opentext.wsu.edu/biopsychological-effects-alcohol-drugs/chapter/chapter-11-alcohol/
  14. https://www.mayoclinic.org/diseases-conditions/seizure/symptoms-causes/syc-20365711#:~:text=Overview,generally%20considered%20to%20be%20epilepsy.
  15. https://my.clevelandclinic.org/health/diseases/22789-seizure#symptoms-and-causes
  16. https://www.uptodate.com/contents/management-of-moderate-and-severe-alcohol-withdrawal-syndromes#H7
  17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5759952/
  18. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/harmful-interactions-mixing-alcohol-with-medicines
  19. https://www.drugs.com/food-interactions/levetiracetam,keppra.html
  20. https://www.drugs.com/interactions-check.php?drug_list=1034-0,1448-858

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

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Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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