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Alcohol and Keppra: Is It a Safe Combination?

Using anticonvulsant medications like Keppra while drinking alcohol can exacerbate the side effects of the medication.

Keppra (levetiracetam) is designed to treat individuals who are diagnosed with a seizure disorder like epilepsy.

Anticonvulsants or antiepileptic drugs are commonly taken in pill or liquid form, and they require a prescription from a physician even though they are not formally designated as controlled substances by the U.S. Drug Enforcement Administration. This is because they do not have a significant potential for abuse and are not medications where the development of physical dependence is a concern.

Mechanism of Action

The mechanism of action of Keppra is not fully understood.

Anticonvulsant drugs are designed to reduce unrestrained activity in the neurons in the brain, as this leads to seizure activity. By reducing the activity of these neurons, anticonvulsant medications like Keppra can be effective in controlling seizure activity in individuals who are diagnosed with different types of epilepsy.

The medication is believed to inhibit the release of calcium in the neurons. Calcium release increases the excitability of the neurons in the central nervous system. This results in reduced firing rates and the reduction of seizures.

Side Effect Profile

Side effects occur in some individuals who use Keppra. Although side effects associated with any drug are possible, individuals who use Keppra according to the instructions from their physician will typically be able to tolerate most of the side effects they may experience.

The most common side effects that occur as a result of using Keppra include:

  • Mild sedation, lethargy, and sleepiness
  • Decreased energy and appetite loss
  • Difficulties with motor coordination
  • Dizziness or headache
  • Mood swings in some individuals

Some people develop more serious side effects that need to be addressed by a physician. Some of these side effects can include:

  • Irritability, agitation, and even aggressiveness
  • Problems with extreme mood changes that can include apathy or depression
  • An increase in suicidal thoughts
  • Psychotic behaviors (hallucinations and/or delusional behaviors)

Anyone experiencing any of these rarer side effects should contact their physician.

There are other very rare side effects that have been reported, such as:

COGNITIVE DIFFICULTIES

Some people using Keppra report cognitive difficulties as a result of taking the drug. These difficulties can include exacerbations of dizziness that can affect the ability to concentrate, problems with mental alertness that reduce the ability to think clearly, and issues with memory.

 

FEELING AS IF INTOXICATED

Some people report that the drug makes them feel as if they are drunk on alcohol. If the person stops using Keppra, symptoms will typically resolve, but there is a risk to re-experience seizures. The use of vitamin supplements, particularly vitamin B6, may help to address this issue.

SKIN IRRITATION

Skin disorders have been known to occur in people using Keppra, but these side effects are infrequent. Those who develop severe problems with their skin due to the use of anticonvulsant medications often need to try many different drugs to control their seizures before they can find a remedy that suits their needs.

Abuse of Keppra

Drugs classified as antiepileptic or anticonvulsant are not significant drugs of abuse.

Benzodiazepines are also used in the treatment of seizures, and these drugs are potential drugs of abuse; however, Keppra is not a benzodiazepine. It is not a drug that is highly sought after for its psychoactive effects, but there are some anecdotal reports of individuals abusing anticonvulsant drugs to achieve sedative-like effects.

Very often, individuals who abuse anticonvulsant drugs will use them in conjunction with other drugs of abuse, such as alcohol.

Abuse More Likely in People With Psychological Disorders

There is a higher rate of drug abuse in people who are diagnosed with psychological disorders. People diagnosed with epilepsy have a higher percentage of mental illness and cognitive dysfunction than those without epilepsy.  

This may increase the risk of substance abuse in this group. It may also lead to the practice of combining anticonvulsants with drugs of abuse.

Seizure Disorders and Substance Abuse

There is also some information to suggest that individuals with untreated seizure disorders may be at a greater risk to develop substance abuse issues, particularly alcohol use disorders. This may be due to attempts by these individuals to self-medicate to deal with associated psychological problems they experience, such as depression, issues with social functioning, problems with social isolation, and other factors.

When these people begin to use anticonvulsants to treat their seizure disorder, they may continue to engage in alcohol abuse.

Alcohol and Keppra

Drinking Alcohol With Keppra

Individuals who take Keppra in conjunction with drinking alcohol run the risk of increasing the potential to develop many of the side effects listed above, including issues with mood swings and potential suicidality. There may be an increased risk for liver and kidney problems when alcohol is chronically combined with Keppra.

Higher levels of alcohol use will most likely result in an increase in mood swings, depression, and potential suicidality in addition to interfering with motor coordination.

The instructions on the medication bottle strongly warn against drinking alcohol when taking the medication. Individuals with seizure disorders like epilepsy should not be drinking alcohol anyway. Alcohol exacerbates seizures and increases dysfunction related to seizure disorders.

Keppra for Alcohol Abuse

Anticonvulsant medications like Keppra have been suggested as potential medications in the treatment of individuals who have alcohol use disorders. There have been several different controlled studies to determine the effectiveness of Keppra in reducing the use of alcohol compared to placebo.

The studies have generally found no benefit to using Keppra in the treatment of alcohol use disorder. At least one study suggested that Keppra may increase alcohol use in individuals with alcohol abuse problems.

Is There a Safe Way to Combine Keppra With Alcohol?

Whenever the general instructions of prescription medication specifically state that alcohol should not be used in conjunction with the medication, it should be automatically assumed that there is no safe way to combine alcohol with it.

Thus, there is no safe dose of alcohol that is acceptable when using Keppra to control seizures.