Can You Stop Taking Keppra Cold Turkey?

Keppra, also known as levetiracetam, is a commonly prescribed medication used to treat epilepsy and seizures. It works by reducing abnormal electrical activity in the brain that causes seizures. While Keppra can be an effective treatment, some people consider stopping their medication, including quitting cold turkey. However, there are risks associated with suddenly stopping Keppra without medical supervision. This article provides a comprehensive overview of Keppra, the potential consequences of stopping it abruptly, and safer discontinuation methods.

What is Keppra and How Does it Work?

Keppra is the brand name for the generic drug levetiracetam which belongs to a class of medications called anti-epileptic drugs (AEDs). It was approved by the FDA in 1999 as adjunctive therapy for partial onset seizures in adults. Since then, it has also been approved for other types of seizures including

• Myoclonic seizures in adults and adolescents 12 years and older
• Primary generalized tonic-clonic seizures in adults and children 6 years and older

Keppra helps control seizures by binding to synaptic vesicle protein 2A in the brain which inhibits release of neurotransmitters associated with seizures. This leads to a reduction in abnormal electrical activity that triggers seizures.

Keppra is available as tablets, oral solution, and intravenous injection. It is usually taken twice per day, with dosing tailored to the individual based on factors like age, kidney function, and response to treatment.

Why Do People Stop Taking Keppra?

There are several reasons why someone might consider discontinuing Keppra treatment:

• Side effects – Keppra can cause side effects like dizziness, drowsiness, fatigue, mood changes, and irritability in some people. For those who find the side effects intolerable, stopping medication may seem like the best option.

• Lack of efficacy – If seizures are not adequately controlled with Keppra, a doctor may recommend adding or switching to another AED that could work better. This would require tapering off Keppra first.

• Pregnancy – Keppra is typically not recommended during pregnancy due to potential risks to the fetus. Doctors may advise discontinuing Keppra prior to conception or as soon as pregnancy is confirmed.

• Kidney dysfunction – Keppra is eliminated from the body by the kidneys. Worsening kidney function may require a dose adjustment or alternative treatment.

• Surgery – Keppra may need to be temporarily stopped before some types of surgeries.

• Personal preference – Some people may simply wish to stop taking medication for seizures if they have been seizure-free for a period of time.

Dangers of Stopping Keppra Cold Turkey

While the reasons for wanting to stop Keppra are understandable, quitting suddenly without medical supervision is risky. Some major concerns include:

• Seizure recurrence – Once anti-seizure medication is discontinued, seizures frequently return. Quitting Keppra cold turkey leaves no time for the brain to adjust, greatly increasing the chance of rebound seizures. Status epilepticus, a life-threatening seizure that does not stop on its own, could occur.

• Withdrawal symptoms – Abrupt Keppra cessation can cause withdrawal side effects like insomnia, headache, anxiety, irritability, and even psychosis in some cases. Gradual tapering under medical guidance can minimize symptoms.

• Medication overload – If taking multiple AEDs, suddenly stopping one could lead to toxic levels of the others. This also raises seizure risks.

• Lack of monitoring – Doctors can watch for problems like seizures or adverse reactions if they supervise medication cessation. Quitting without oversight removes this safety net.

Clearly, while stopping Keppra may be appropriate in some circumstances, doing so spontaneously can jeopardize health. Always consult a doctor first.

How to Safely Discontinue Keppra

When medically advised to stop Keppra treatment, doctors recommend a gradual tapering schedule to avoid complications. This carefully controlled process may progress as follows:

• The initial tapering dose and timeframe will be tailored to the individual situation. Slower reductions tend to be better tolerated.

• Dosage may be decreased by 250-500 mg every 1-2 weeks in older adolescents and adults to start.

• For children, initial reductions may be 125-250 mg every 1-2 weeks.

• Dose adjustments can be made based on how the taper is tolerated and the person’s clinical response.

• Towards the end of the taper, it is typical to reduce dosage every 2-4 days.

• After complete discontinuation, the person will need to be monitored closely for any return of seizures.

• Some doctors may utilize blood tests during tapering to ensure levels do not drop too quickly.

• If withdrawal symptoms become intolerable, a more gradual taper may be required.

Patience and strict adherence to the prescribed tapering schedule is vital for success. Never attempt to modify or discontinue Keppra independently without explicit medical approval.

What to Expect After Stopping Keppra

The aftermath of stopping Keppra depends largely on how rapidly medication was reduced. Here are some possibilities individuals may encounter:

• Seizure recurrence – As the protective effects of Keppra wear off, seizure activity can resume. This may happen immediately or up to several months later.

• Withdrawal symptoms – These could include anxiety, insomnia, or balance problems in the days to weeks following last dose. Symptoms should resolve faster with slower tapers.

• No initial change – Some people report feeling no different for the first few weeks after discontinuation. However, seizures may still return later. Ongoing monitoring is essential.

• Medication adjustments – If taking other AEDs, remaining medications may need dose changes after quitting Keppra to maintain optimal levels.

• Long-term seizure control – While possible, remaining seizure-free indefinitely after stopping Keppra is unlikely without an alternative treatment plan. Most will need a new medication regimen.

The takeaway is that abruptly stopping Keppra often has consequences. Working closely with epilepsy specialists when making medication changes can help reduce risks and prepare for changes ahead. Be sure to communicate any concerns quickly so adjustments can be made.

Key Considerations When Stopping Keppra Treatment

• Do not attempt to discontinue Keppra suddenly without medical supervision. The results could be disastrous.

• Adhere exactly to the prescribed tapering schedule for the safest outcome. Never adjust doses independently.

• Withdrawal symptoms may be managed with supportive treatments or a more gradual taper if they become intolerable.

• Seizures frequently return following Keppra discontinuation, but timing varies. Extended monitoring is crucial.

• Expect to start a new medication regimen if stopping Keppra after relying on it long-term for seizure control.

• Check in regularly with your doctor throughout the tapering and transition process. Promptly report any issues.

While Keppra can be effective for managing seizures, there are circumstances where discontinuing its use becomes necessary or preferred. Quitting Keppra cold turkey without medical oversight is never advised, as the risks are substantial. A gradual tapering schedule overseen by knowledgeable epilepsy specialists allows the best chance of safely transitioning off Keppra when appropriate. With close monitoring and communication, complications can be minimized. But individuals must understand that seizure control with a different medication plan will still be required for most people long-term.