Can You Drink Alcohol While Taking Keppra?

Having a seizure can be an unpleasant experience, especially for those with epilepsy. Keppra (known by the generic name levetiracetam) is commonly prescribed to treat seizures in epilepsy patients. But what about mixing Keppra and alcohol? How does Keppra affect us, and can we drink alcohol while taking it? Let’s learn more about levetiracetam and alcohol, and what happens if we mix the two.

Keppra may be prescribed to control various types of seizures, but it is not a cure for epilepsy. Therefore, most patients who are prescribed Keppra need to be on it for a long time and require a doctor’s supervision when they stop taking it.

What Is Keppra and How Does it Work?

Keppra is part of a class of medications known as “anticonvulsants,” that are used to treat seizures in people with epilepsy. The exact dosage depends on the patient but is typically taken daily. The amount of time someone stays on Keppra also varies depending on the patient, but some take it for up to five years. If you stop taking it, it must be done slowly and under the guidance of a doctor.

There are few Keppra uses beyond treating epilepsy, but it is sometimes used to treat seizures during alcohol withdrawal.

But what causes a seizure? Seizures are caused by too much “excitatory” activity in the brain. Anticonvulsant drugs, in general, alter electrical activity in the brain’s neurons and increase GABA, which calms this excitatory activity. Keppra works by decreasing the excess excitation in the brain and increasing inhibition. 

Side Effects of Keppra

The side effects of Keppra vary depending on the type of seizure being treated, but they can all be pretty worrisome:

• Aggression
• Anxiety
• Personality changes and mood swings
• Drowsiness
• Delusions
• Uncontrolled anger (known as “Keppra rage”)
• Feeling disconnected from reality
• Depression and suicidal thoughts

If you are experiencing thoughts of suicide, please seek medical attention. In the United States, you can reach your local crisis hotline by dialing 988. Click here for a list of mental crisis phone numbers by country. 

Is There an Interaction Between Keppra and Alcohol?

So, we know what Keppra is and what it does, but what does the Keppra alcohol interaction do to us? Well, not only does it affect our brain, but it affects other parts of our body as well. Let’s examine each of these in more detail.

Effects on Our Brain

Remember those nasty side effects of Keppra we talked about earlier? Well, bringing alcohol into the mix can exacerbate them. Since alcohol affects the brain, it can interfere with the work that Keppra is trying to do to treat the brain. The combination can cause a range of reactions from increased drowsiness to extreme sedation to mood swings to depression to suicidal thoughts.

The use of alcohol on its own can induce a seizure in some people with epilepsy. Combine that with making Keppra less effective, and you have a recipe for trouble.

The bottom line is that it’s best to avoid alcohol while taking Keppra, and definitely not to have more than 14 units of alcohol per week if you do plan to drink.

Even if we’re not taking Keppra, alcohol is bad news for those of us with epilepsy. Consuming more than two drinks per day puts epileptics at risk for seizures, so it’s best to avoid it if you have epilepsy. Alcohol is actually one of the most common triggers for epileptic seizures.

While most alcohol-related seizures occur as a result of withdrawal, heavy alcohol use can increase the risk of developing seizures in people who don’t have epilepsy. One study shows that a person’s seizure threshold — meaning how likely the brain is to have a seizure — increases after heavy alcohol use (particularly three drinks or more per day).

Effects on the Central Nervous System

Both alcohol and Keppra depress the central nervous system (CNS), slowing down the body’s functions. When we combine multiple substances that depress the central nervous system, we set ourselves up for a major imbalance of chemicals in the brain that can lead to severe sedation and even a coma. Not only that, combining alcohol and Keppra can heighten each other’s side effects of dizziness or fatigue, both of which are symptoms of CNS depression. 

Effects on Our Liver

We know alcohol damages the liver, but what about Keppra? As it turns out, Keppra has been linked to liver damage in some rare cases. While the research on this is minimal, it’s not worth the risk of further damaging the liver by adding alcohol to the mix.

Effects on Our Kidneys

Alcohol damages the kidneys by disrupting the hormones that regulate kidney function. Keppra is mainly processed and eliminated by the kidneys, so any damage to the kidneys from alcohol means that the kidneys can’t eliminate as much Keppra from the body. This means our dosage of Keppra needs to be reduced, which gives us less protection against seizures.

Effects on Our Mood

We’ve talked about the side effects of Keppra and how mood swings and depression are among those. But did you know that alcohol also has a negative effect on our mood? While that first sip may make us feel relaxed and ready to socialize, alcohol can conjure up a whole lot of negative emotions. Once the alcohol has left our body, we experience a sudden decrease in GABA, the calming inhibitory neurotransmitter, which leads to feelings of restlessness, anxiety, and irritability (For more information, check out our blog “Why Does Alcohol Make Me Moody the Next Day?”). If we combine these negative effects of alcohol with the side effects of Keppra, we have a much higher risk of severe mood swings and suicidal thoughts.

How Long After Stopping Keppra Can I Drink Alcohol?

Say we’re ready to get off Keppra and have been slowly doing so under the supervision of our doctor, now what? How long do we need to wait if we plan to consume alcohol? It can take up to 44 hours for Keppra to be completely out of our system after the last dose, so it’s best to wait at least that long before consuming any alcohol. But just because our seizures are under control doesn’t mean we’re in the clear. Keep in mind that consuming more than two drinks per day puts epileptics at risk for seizures, so it’s best for anyone who has epilepsy to avoid alcohol. And since there is limited research on Keppra, and the dosage varies so widely among patients, it’s best to talk to your doctor before consuming any alcohol.

Tips To Stay Safe While Taking Keppra

Mixing alcohol with Keppra has some pretty nasty effects, but luckily there are plenty of things we can do to stay safe and prioritize our health. Keep these tips in mind:

1. Know your triggers. Flashing lights aren’t the only thing to watch out for when avoiding seizures. Alcohol is a common trigger for epileptic seizures, and so is lack of sleep. And since alcohol contributes to a lack of sleep, this effect is compounded. Not only that, hormone changes and dehydration are also linked to epileptic seizures, which alcohol also contributes to.
2. Stick to non-alcoholic beverages during treatment. Mocktails are a safe alternative to alcohol as long as they are truly alcohol-free. Keep in mind that non-alcoholic beer still contains trace amounts of alcohol and may still interact with certain medications, so be sure to talk to your healthcare provider if you plan to drink it while taking Keppra.
3. Seek support. Support from loved ones or a community can help tremendously during any treatment. We can also talk to our loved ones about our condition so we won’t feel put on the spot during activities that involve drinking.
4. Practice brain-healthy activities. Activities such as yoga and meditation as well as practicing mindfulness can calm the brain, so instead of turning to that evening glass of wine to calm down, we can calm both our body and our mind in a healthy way. Studies show that meditation and practicing mindfulness can work wonders for epilepsy patients, so it won’t hurt to add some yoga or meditation to your daily routine (For some ideas for mindful activities to try out, check out our blog “11 Mindfulness Exercises and Activities for Adults”).

All of these activities will lead you down the road to better health and safety while taking Keppra.

A Bit of Brainy Inspiration

Undergoing treatment for epilepsy can be a lot to think about, and since the brain is such a complex piece of equipment, there are still many mechanisms to its interactions that we don’t fully understand (ironic, isn’t it, since we use our brains to study other brains.) Keppra in particular is understudied, which is even more reason to leave the booze behind when taking it. And just remember that we’re not only doing our brains a favor by cutting out the booze, we’re opening up our lives to a whole world of happier, healthier habits.