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  #1  
Old 01-29-2012, 02:59 PM
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Unhappy Antidepressant use with Keppra


I've been on Keppra for almost 3 months now, and the last 6 weeks having been a high dose of 1000mg twice a day.

At my lower doses, I never noticed any real change in irritability, mood swings or depression. At the higher level, it's really bothering me. I can start crying out of nowhere, I get really annoyed quickly, and just lose the will to do anything or even get out of bed.

I've never had any depression before, so this is a new and scary experience for me. On top of this, I'm also experiencing memory loss and word recollection side effects of the Keppra, which adds to my mood issues and feelings of anxiety in that moment.

I have a neurologist appointment on Tuesday to get the results of an LP, and to just chat with him about how this new level of dosage is working (it's controlling the seizures, there's no question of that, but I am not happy with how it's affecting me in other ways). Is there anything I could suggest trying in terms of an antidepressant to control my issues, or would a better approach be to lower the Keppra dosage and maybe supplement it with something else? I really don't know much about Keppra and any type of SSRIs. I've read about Klonapin for anxiety working with Keppra since both are broad range anti-epileptic drugs, but I don't think that's what I need for the most part (it might help in the moment when I start to panic, but it's not going to help with my mood - I don't think).

What are your thoughts or experiences? I'd be very interested in reading them and taking any information to my appointment I can.
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Old 01-29-2012, 03:29 PM
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Hi Britishguy.

Keppra is also known as Kepprarage & well known to cause mood problems or behaviour changes. Speak to your neurologist about any changes you have noticed eg - mood changes, problems with memory & discuss with them if anti depressants would be an option for you.

I have been on Keppra for 4 years & I have been lucky enough not to have any bad side effects with the Keppra & haven't had Kepprarage. At one stage I was on 1500mg Keppra twice a day as well as Tegretol & Neurontin. I had a video EEG in November 2010 & when I was in hospital for the EEG the epitiologist took me of the Neurontin (at my request) & lowered the Keppra to 1000mg. I'm now on Keppra 1000mg twice a day & Tegretol 400mg twice a day.

There are some other people on here who have been on Keppra & had problems with Keppra rage so they may be able to help you more.
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Old 01-29-2012, 09:24 PM
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Im on Keppra XR and I take 3000mgs a day, 1500 mgs twice a day. But to help with the irritability and mood changes, my dr who I started seeing in November 2010, told me about Vitamin B-6. He said it helps to control the mood swings that Keppra causes. Ive been taking it since then and Ive noticed a huge difference. If anything, I would dry that and see if it works for you
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Old 01-30-2012, 11:11 AM
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I'll be sure to keep that in mind. I picked up a drink mixer (walmart's own version of the Mio liquid drink enhancers) which has B6 and B12 in it (also nice since I'm on B12 shots as per neurologist) so we will see if that does anything. Thanks for the useful info.
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Old 01-30-2012, 11:16 AM
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I'm also on a high dosage of Keppra and take Zoloft, also. Some anti-epileptic drug's and epilepsy itself can/does cause mood disorders in some folks.
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Old 01-30-2012, 02:34 PM
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I'm of the opinion that you want to take as few prescription drugs as is possible. So, I would definitely try a B-complex supplement or look into switching to another anti-epileptic drug before I mixed it with an anti-depressant.
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Old 02-02-2012, 08:36 AM
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My neurologist said he didn't want to add an antidepressant into the mix, instead he wants to try to lower my Keppra dose from 1000mg twice a day to 750mg twice a day, and slowly work in some Lamictal to see if that picks up the slack in partial seizures that the extra 250mg Keppra seemed to be catching, and might help with the mood.

Fingers crossed.
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Old 06-15-2012, 09:46 AM
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I know this is an old thread, but I wanted to throw in some input/question. As many of you know, I'm on Keppra, 1000 mg am/pm. I've been dealing with a lot with having to leave my former job position while deployed (though I'm still getting paid right now - one benefit of the military at least!), not being able to drive around here in upstate New York where there is ZERO public transportation, and am just kind of in a bad place, though I know it could be a LOT worse than it is.

As a result of all of this, the doc had me go to a psychologist... I don't think I'm that bad, honestly, but I've had a couple of people (the doctor and the psychologist) suggest antidepressants because I have a history of some anxiety (nothing severe though), and a background with some depression - especially in my family. I don't FEEL depressed most of the time, just kind of up and down/irritable/crying easily, and I guess I've been feeling a bit apathetic (lazy better word?) lately, but I know those things are pretty common with Keppra. Though I have had some problems with these things in the past before Keppra, so who knows if it's just the Keppra, or a combination of the new medication with everything else that changed. I'm wondering if antidepressants would even help if it's the Keppra causing the issues? How they might interact with Keppra? I have an appointment to see a psychiatrist when I come back from leave in a couple of weeks. It's funny because I've been way more depressed than this in the past (more constant), and nobody ever suggested antidepressants then, but now everyone is... I'm wondering if they just hand them out more now that I'm not in college because so many military members are dealing with deployments/stress/etc.? I guess I have more to be stressed over than I did back then, and I am wondering, will they actually make me feel more "stable"? Initially I scoffed at the idea of taking MORE medication, but after realizing I've been cursing up a storm everytime things go a little off, I'm thinking maybe it wouldn't be such a bad thing...
sorry, I'm rambling now! Anyway, just looking for some more input from anyone whose used antidepressants with Keppra (or other anti-epileptic drugs too, as Keppra is only the first med I've used, and I know there is always the possibility they could switch me.
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Old 06-15-2012, 11:46 AM
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I can't speak to antidepressants as I've never taken them. But, I can tell you that Keppra can cause much of what you are describing, and that I have had docs ask me about taking antidepressants when I tell them of my Keppra side effects.

I never liked the idea of using another drug to mask the side effects of a current drug, so I say no everytime. Plus, like I said, all drugs have side effects and I like to err on taking as few as possible to not confuse things too much. And, in my case, I felt certain it was Keppra, because my feeling down didn't start till a drug switch and I can clearly remember and have been told how I acted prior to switching drugs.

If anything, you might want to start taking a B-complex vitamin, as B12 has been reported to help with Keppra related mood issues. Also, I'd express to your current docs that you aren't comfortable taking more drugs (if indeed that is your desire) and so either they look at this as a Keppra issue or start letting you know what your options are as far as switching to another E drug.

It flat pisses me off when they jump right on the psychology antidepressant bandwagon, as though the patient must have a problem, because it can't be the all-wonderful drugs they prescribed or just being naturally down due to a given situation.

Good Luck and trust yourself.

Last edited by Dignan; 06-15-2012 at 11:50 AM.
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Old 06-15-2012, 01:17 PM
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I tend to be a "minimalist" when it comes to doctors and medications... so my instinct would be to avoid adding another medication to the mix unless it's absolutely necessary. The brain meds -- whether anti-seizure drugs, or anti-depressants -- are so powerful that you have to be very careful going on and off them, they have a lot of side effects, and they can affect each other in unpredictable ways. I know anti-depressants can and do help a lot of people, but if there's a chance you can be okay without them, I recommend that you steer clear.

Anti-depressants have definitely become ubiquitous over the last decade. I think it's in part due to pressure from drug companies as well as health insurers. Things like counseling are not covered to the same extent that the meds are.
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Old 06-16-2012, 04:18 PM
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Originally Posted by Nakamova View Post:
I tend to be a "minimalist" when it comes to doctors and medications... so my instinct would be to avoid adding another medication to the mix unless it's absolutely necessary. The brain meds -- whether anti-seizure drugs, or anti-depressants -- are so powerful that you have to be very careful going on and off them, they have a lot of side effects, and they can affect each other in unpredictable ways. I know anti-depressants can and do help a lot of people, but if there's a chance you can be okay without them, I recommend that you steer clear.

Anti-depressants have definitely become ubiquitous over the last decade. I think it's in part due to pressure from drug companies as well as health insurers. Things like counseling are not covered to the same extent that the meds are.
I really agree with Nakamova. There is a time and a place for more medication, but you don't seem like you are that bad. Do a little soul searching. Deal with the issues you can, like adjusting to your changes. And reveiw the Keppra side effects. I think you will see that most of what you are telling us is listed as a side effect. My son is in the millitary. I agree that you may have some extra stuff you are dealing with at the moment. But it says something towards your personality that you are someone tough just by enlisting. If you feel you need a little help to get over this hump, then get some help and don't feel bad about it. Thats why I say do a little soul searching. Only you know what you can and cannot cope with.

So the question is... what to do:
1. Nothing and live with the side effects.
2. Change anti E drug.
3. Add another drug into the mix.

Each option has its own side effects. It sounds like there are a lot of people who do really well on Keppra and some that just don't. I was like you... Happy, low stress, pretty normal coping skills... then Keppra came along and caused ALL the same stuff in me as you described above. I told my doctor and she instantly wanted to put me on more meds and send me to the Psychiatrist. I know myself well enough to know that Keppra did this to me. I don't have a psych issue. I stopped the Keppra, but now on NO anti E meds doesn't feel right either. So, I'm still trying to figure it out myself.

I guess what frustrates me is that its not cut and dry and the patient is often left trying to figure it out. We feel the doctors should figure it out for us, but they all to often just want to band aide it up with more meds. For me, more meds were not an acceptable option. I hope you are able to sort it out and decide on an acceptable option for yourself.
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Old 06-16-2012, 04:34 PM
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Originally Posted by Dignan View Post:

It flat pisses me off when they jump right on the psychology antidepressant bandwagon, as though the patient must have a problem, because it can't be the all-wonderful drugs they prescribed or just being naturally down due to a given situation.

Good Luck and trust yourself.

But you have to wonder why this is their typical route...
Years of experience that there really isn't much choice when it comes to epilepsy treatments?
Taught to do it this way at their yearly confrences?
Given perks from the drug companies to do so?
Tired of their profession and they just want to keep up somewhat quiet?
Each new drug means more office visits = more income?
They really want to help us and they think this is the right way?

There are probably many reasons and I am just learning, so I still wonder. But in the bottom of my heart, I think good about people and believe these docs want to help us. My doc said she was trying to give me a better quality of life with Keppra. I'm not convinced that is what I got. But still left wondering what to do next.
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Old 06-16-2012, 05:55 PM
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Well they do have me seeing a social worker/psychologist still yet so it isn't just medicine that they're trying to give me. I have a family history of depression and bipolar disorder on both sides of the family and have some history of depression and anxiety myself BEFORE epilepsy came along. I think that is what they are worried about... plus the military has a bad reputation for not taking care of its soldiers and their mental health issues, especially upon returning from deployment. I think they kind of just want to do what they can to make it all better - especially when I start crying in the first ten minutes of my session. I was also talking ridiculously slow (a sign of depression, though I was just really out of it). I was a psychology major in college and want to possibly go get my Ph.D and be a research psychologist later... if I was dedicated /smart enough for med.school I would go for being a psychiatrist, and I want to help. I can imagine they want to do the same. That being said, I REALLY don't like my irritability/moodiness - it helped ruin my last relationship before this one.which is what made me much more depressed for like three additional months - but I'm afraid to try other drugs because I also don't want to.feel brain dead. I'm tempted to try something to help stabilize my mood and if I don't like how they're affecting me then stopping them. But who knows. I'm visiting family and taking leave for ten days before I see the psychiatrist and may change my mind and feel great by then.

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Old 06-16-2012, 06:03 PM
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Hello,
I don't have any advice as I am in the same boat, but I am on keppra and wellbutrin....which I now know is a horrible combination as it lowers your seizure threshold. I too never struggled with depression prior to keppra. I was on 1500mg BID but reduced it to 750BID. I was told that with my family history OF COURSE i was depressed so I thought geez i must be pretty messed up. BUT i have never had the fatigue, want to stay in bed all day, lack of motivation and irritability that I have now! I can be fine one minute and then all of a sudden my husband will say something totally innocent and I either get mad or cry! It is crazy!! I tried ssri's to no avail and was put back on wellbutrin but thanks to CWE I was told about a magnesium, b6 and b12 combo that worked for the daughter of a woman on here. (sorry new to this and cant remember her name off hand) I am going to try that when I meet with my new neurologisit in aug but I can sure relate to the docs sending you in to be evaluated and then more meds being added when it wasn't an organic problem to begin with! Good luck! Hope this helps
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Old 06-18-2012, 10:50 AM
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I take 2000mg of keppra/day and also 20mg of fluoxetine (prozac). I have been on the prozac fora few years but the keppra for a month or so. Started the prozac after my first seizure a few years ago because it caused severe anxiety and panic attacks. I have not had any bad symptoms with my keppra though, it could be from the prozac but i am not sure.
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Old 06-18-2012, 02:43 PM
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I take 500mg of Keppra XR once a day. It's a low dose, and if I ever manage to find a new neurologist, I will increase it.

I'm also on 20mg of Citalopram and 50-100mg of Trazodone. I have frontal lobe epilepsy, so we don't know where my anxiety/depression stems from. But the fact is that I need all of these medications every day to live normally. At least semi-normally.

I think you should add an antidepressant as a last resort in your case. But I do want you to know I have no problems with my meds.
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Old 06-19-2012, 08:02 AM
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I am on keppra and already dealt with mood issues (postpartum depression and panic disorder) they pit me on klonopin for the panic attacks and had me on 2 ssri. (Remeron and celexa) a couple days after a remeron increase I suffered HYPERMANIA to the 10th power. Scared me.

They took me off both antidepressants and put me on abilify saying I have bipolar 1. I am still not right but telling your Dr and keeping communication there is key.
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Old 07-04-2012, 03:12 PM
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Just an update: I was put on a low dose of Celexa to help deal with anxiety and some mild depression. The anxiety is something docs have thought was an underlying issue BEFORE all the seizure issues started. Interestingly, things I had dealt with in the past may be linked to anxiety and I didn't know it (like vocal chord dysfunction - where my vocal chords sorta close up when I breathe and feel like I can't get a good breath - it seems to happen most frequently during times of high stress) and some other issues I haven't shared on here. I started the medications about a week ago. So far no issues, and I still HAVE moods, but I don't feel numb/much different, which is good, because I was worried about that. I did notice my irritability has calmed and I don't find myself getting as frustrated with things (again, frustration/irritability were things I dealt with before I was ever on Keppra - Keppra just exasperated the issue). I also haven't randomly started crying at all in the past week, haha.

I am also getting therapy to help deal with how I deal with situations.

Katie, my psychiatrist also noted on my EEG results that there was slowing in my frontal lobe and that can cause depression issues. I feel like most of my epilepsy symptoms are related to temporal lobe problems, but my frontal lobe is where they found abnormalities on my last EEG.
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Old 07-04-2012, 04:00 PM
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I'm glad the Celexa is helping, hope you feel better all around.
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Old 07-04-2012, 04:11 PM
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Sounds like some good news!
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