Yes, Keppra (levetiracetam) is an anticonvulsant, also called an antiepileptic drug. It is FDA-approved to treat several types of seizures in both children and adults. What makes it unusual is that it works through a completely different mechanism than older seizure medications, and it is chemically unrelated to any other anticonvulsant on the market.
What Keppra Is Approved to Treat
The FDA has approved Keppra for three specific uses. First, it can be used on its own or with other medications to treat partial-onset seizures in patients as young as one month old. Second, it serves as an add-on therapy for myoclonic seizures in people 12 and older who have juvenile myoclonic epilepsy. Third, it is approved as add-on therapy for primary generalized tonic-clonic seizures in patients six and older with idiopathic generalized epilepsy.
In practice, doctors also prescribe Keppra off-label for other seizure-related situations, including status epilepticus and seizure prevention after brain surgery or traumatic brain injury. Its broad age range and multiple formulations make it one of the most widely prescribed anticonvulsants worldwide.
How It Works Differently From Other Seizure Drugs
Most traditional anticonvulsants work by blocking sodium or calcium channels in nerve cells, or by boosting the brain’s main calming chemical (GABA). Keppra does none of these things. Instead, it binds to a protein called SV2A that sits on tiny sacs inside nerve endings. These sacs, called synaptic vesicles, store neurotransmitters and release them when a nerve fires.
Research published in the Proceedings of the National Academy of Sciences confirmed that SV2A is both necessary and sufficient for Keppra to bind in the brain. In animal studies, mice lacking SV2A showed reduced neurotransmitter release and developed seizures, suggesting SV2A plays a key role in keeping nerve signaling stable. Keppra appears to enhance a function of SV2A that prevents the abnormal bursts of electrical activity that cause seizures. This unique target is why Keppra is classified as chemically unrelated to every other antiepileptic drug.
Available Forms and How It Is Taken
Keppra comes in several formats: immediate-release tablets (250 mg, 500 mg, 750 mg, and 1,000 mg), a grape-flavored liquid solution (100 mg per milliliter), and an intravenous form for hospital use. An extended-release version, marketed as Keppra XR, is also available for patients who prefer once-daily dosing. Generic levetiracetam is widely available and typically much less expensive than the brand name.
Low Risk of Drug Interactions
One of Keppra’s biggest practical advantages is that it rarely interferes with other medications. Many older anticonvulsants speed up or slow down liver enzymes that process other drugs, which can weaken birth control pills, blood thinners, or chemotherapy agents. Keppra does not significantly affect these liver enzymes. Clinical studies have confirmed that it does not reduce the effectiveness of common blood thinners like apixaban or rivaroxaban, and it does not meaningfully alter the processing of other drugs that pass through the liver. This makes it a particularly useful option for people who take multiple medications.
Side Effects to Know About
The most commonly reported side effects are drowsiness, dizziness, fatigue, and weakness, particularly when first starting the medication or increasing the dose. These often improve after the first few weeks.
The side effect that sets Keppra apart is its potential to cause mood and behavioral changes. About 16 to 18% of patients experience some form of behavioral side effect, ranging from irritability and emotional instability to depression. Around 13% of adults report symptoms like mood swings or low mood. More severe reactions, such as agitation or hostility, occur in roughly 0.7% of cases, and psychotic symptoms develop in about 1.4%, a rate notably higher than with most other seizure medications. These psychiatric effects are even more common in children, reported in up to 37.6% of pediatric patients in long-term studies. If you or someone you care for notices significant personality changes after starting Keppra, that is a recognized effect of the drug and worth discussing with the prescribing doctor promptly.
Safety During Pregnancy
Keppra is considered one of the safer anticonvulsants for use during pregnancy. Data from more than 1,800 pregnancies exposed to levetiracetam alone, including over 1,500 with first-trimester exposure, show no increased risk of major birth defects compared to the general population. The baseline risk of birth abnormalities in any pregnancy is about 2 to 3 per 100 babies. Keppra does not appear to raise that number.
For comparison, other anticonvulsants carry meaningfully higher risks. Carbamazepine and topiramate raise the rate to 4 to 5 per 100. Phenytoin and phenobarbital reach about 6 per 100. Valproate, the highest-risk option, is associated with approximately 10 birth defects per 100 babies. Available studies also show no clear increase in neurodevelopmental problems or growth issues in children exposed to Keppra before birth, though the data on long-term development remains limited. The UK’s Medicines and Healthcare products Regulatory Agency specifically identifies levetiracetam, along with lamotrigine, as the safer options among reviewed antiepileptic drugs during pregnancy.