Keppra and Personality Change

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tcedwards

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Help! My husband had his first Nocturnal Seizure a little over a year ago. He use to be the most laid back, easy person to get along with. His seizures started around the same time he was losing his mother to cancer. After his second seizure, he was started on Keppra. He only had one other seizure. His mood comes and goes. He will be okay for a while and then will go days of being withdrawn. At times, his anger comes in outbursts. He assumes the worst in everybody and every situation. I don't know how to help him.
 
Hi tcedwards --

1. Folks have found that taking a B-Vitamin suppleemnt with B6 in it can help with the moodiness. In general taking it in the morning is better than the evening. (Check with his doc before taking any supplements).

2. If his seizures are controlled, ask his neurologist about backing off his dose slightly to see if it helps with the side effects.

Best,
Nakamova
 
Welcome TC

I had similar side-effects when I was on Keppra too.

I'm normally very easy-going but when on that drug I was either angry at the world or thought the world was angry at me.

I tried to take the B6 but I was so spaced out & forgetful that I never got to take it regularly. I do know people on this site that take keppra have said it helps.

I do feel for your hubby, I can only imagine what he's going through having to deal with losing someone close & discovering he has seizures at the same time.
 
tcedwards,

First of all, sorry you and he are going through this. It's miserable and hard on a marriage. Be sure to take care of yourselves and each other as best you can through all this.

It could be the Keppra, auras, or the seizures making him feel that way. On days when I'm going to have a seizure I'm hell on wheels. After a seizure I'm so tired I just want everyone to go away, and when they wouldn't I'd kind of lose it.

Also, Keppra made me into a very angry person, peppered with sullenness and general non-socially appropriate behavior. People in here say B6 helps. Maybe it helped me a little, but not to a really noticable level. Maybe it would have been even worse had I not taken it at all.

Having my own space helped. My own space = somewhere only I was allowed to go and retreat to. Like a bear to her den. At least it protected the people around me from my outbursts (for the most part). Then when I felt better I'd come back out. Easier for me since I live alone, but I have a snoopy mother and snoopy friends. I took back the keys to my house!
 
Having my own space helped. My own space = somewhere only I was allowed to go and retreat to. Like a bear to her den. At least it protected the people around me from my outbursts (for the most part). Then when I felt better I'd come back out.

Exactly! That's what I found most helpful so far ;)
 
I was taking 2 x 100mg B-complex (100mg B6) per day (morning and night). I didn't think it was helping much until I dropped it to once a day because I was scared of taking too much. Boy was I nasty! I put it back up and it helped.

To be honest I don't know what I want to do. The immense depression I felt has gone somewhat, some of that I put down to Lamictal withdrawl. However, I'm left on keppra now feeling tired, irritable and generally not caring about anything.

As an example - I took my daughter (5) to the hairdresser 2 days ago and I heard her say to him something about "too short". I was having my hair washed at the time, and I didn't have the energy or motivation to get up and find out what was going on. I just couldn't find the will to care. I was willing to let my daughter's beautiful hair possibly get cut off because I couldn't find the effort within me to get up and check.

Keppra can be a wonder drug or a drug from hell. I'm amazed they put him on that first. For me it's been pretty much the drug from hell. First week I felt high (almost took off the end of my finger making dinner one day, couldn't focus, was dizzy and "doped") I was giggly and hypersensitive to touch. Then there was a sudden shift and I became moody as hell. I was angry at everyone and everything for no reason whatsoever, I hated the world. Then came the depression (after the lamictal was gone) I was so sad it physically hurt. I would imagine laying there stabbing myself in the chest to make the pain go away. It is without a doubt the lowest I have ever been in my life. My Pdoc blamed that on lamictal withdrawl and I did come out of it, but now I am left with anger and an unwillingness to do anything. A part of me is wanting to stick it out in the hopes it will improve since keppra doesn't give me the immense migraines that lamictal did. A part of me just wants to dial the clock back and be on lamictal right now.

If nothing else though, get him on a strong B complex. Possibly switch it to 3x a day dosing too. Keppra has a very short halflife, sometimes people feel more stable with 3 doses rather than 2. I'm on 500 x 3 (I have my mobile phone set to alarm for the middle dose and don't turn the alarm off until I've swallowed the tablets, otherwise I forget, I barely know what day it is any more)

Speaking as a mother, if I knew then what I know now about keppra I wuldn't have made the switch in the first place. I hate the person I've become on it, I have zero tolerance for anything, even things like getting the kids to brush their hair in the morning can send me into an internal rage and an external foul mood (obviously the kids recognize this even though I try not to blow my lid).

Perhaps speak to the doctor about the possibility of a drug like lamictal as monotherapy instead, I find it more of an upper as opposed to the downer of tegretol/depakote. I was a happy person on it (and my sex drive was great!) One downside is it tends to take away your smarts somewhat, but then pretty much every AED does. It also gave me major migraines. In retrospect though, those migraines are better than being a total cow to everyone. At least I wanted to go out back then, I enjoyed my social life.... Now I just want the world to bugger off and leave me alone. One thing to be aware of though is that drug switches are equally nasty. If he does change drugs, he'll be on a combination for a while and that is 1-2 months of hell in general, for an uncertain outcome. It's what's putting me off switching back now.

I don't know what to suggest as to how to help your husband from your point of view. As a new diagnosee he'll also be angry in a "why me?" way beyond what the keppra would do. It's a lot to come to terms with, suddenly having people telling you you can never scuba dive or sky dive or drive or whatever. Even if you never intended to do any of those things, it becomes a really big deal. "now I'll never be able to....." etc. My mum tried to support me (she also had epilepsy) but to be honest I just wished she'd leave me alone. My husband generally just leaves me alone and lets me bring up what I want when I want. I try to convey to him what a mental mess I'm in at the minute though :p

Perhaps you need to ask him. Do you want me to be proactive and try and help you through researching stuff etc, or would you prefer to be left alone and figure this out yourself. If he goes for option #2, point out these forums and other places. Personally I'd go for #2. I want to be left alone to try and figure this out. I'm doing everything in my power to try and make this mess better, I hate who I am. However, if he's depressed he may not be feeling that and may want to be left alone to wallow. In which case you'll have to interfere a little because he won't do it himself =\

Sorry for the somewhat disjointed post. Keppra apparently is supposed to help in the smarts dept. 3 months in and I feel more of an idiot than I ever did on lamictal! My disjointed rambling thoughts and this very small reply box are making things difficult!

***edit***
wow that post was bigger than intended!
 
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Hi tcedwards,

I'm so sorry to hear of your husband's difficulty and the loss of his mother.

I also take Keppra- 3000 mg. a day along with another AED. Mood swings/depression are a common side effect of Keppra, as with many other AED's, so do mention it to his neurologist.
From the PDR:

Keppra Warnings & Precautions

Antiepileptic drugs, including KEPPRA, increase the risk of suicidal thoughts or behavior in patients taking these drugs for any indication. Patients treated with any AED for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, and/or any unusual changes in mood or behavior.

Some of the AED's (Lamictal is one example) are also used for bipolar patients, so the mood swings may not be as bad.
 
I haven't been here for a while but I have a small update on my relationship with Keppra...

When I started out it was pretty good, with occasional outbursts of anger/rage here and there but fine most of the time. But last week was really bad because every time I got angry, a really deep depression with suicidal ideation followed. It lasted up to 4 hours each time and then came back to normal, happy me. I confided in a friend (a fellow psych student) who in turn wanted some advice from one of our lecturers on how to effectively help me , who in turn as a registered clinical psychologist has a duty of care towards all her students and had to make sure I wouldn't do anything silly and made a tentative appointment for me with one of her colleagues for the next day. I agreed to go but I was completely fine during the visit of course, because I am fine except for the outbursts. He agreed that it must be medication-induced and we also observed that the worst 'episodes' seem to occur a week prior to my period. So for now they will all have an eye on me to see what happens. I need to see that guy once a week for a while just for support as he put it and my lecturer will be also informed about my 'progress'. I think if it turns out that a flare up is correlated with PMS I will stick with Keppra and just take extra precautions for that week. If it's totally unpredictable, though, I will need to consider med change even though it works wonders for my seizures.

I have been taking B6 for more than a month now and despite the fact that I wasn't taking it from the start, the emotional side effects actually worsened over time. I still hope I will sort it out somehow and will be able to stick to it because mere thinking about another trial and error process of finding a new med makes me want to cry.
 
An update on how things are going for me now.

5.5 months since I started Keppra and 4.5 months since I stopped the lamictal.

I've turned into a total supplement junkie, but I can now say that I'm actually feeling good. From what I've been reading and further research, I honestly think that a lot of the worst times I went through were lamictal withdrawal. It took my body a long time to recover.

Another thing I discovered... my thyroid was slightly hypo. It was in the range that they didn't want to treat it, but I literally couldn't move, I was sleeping so much, I had zero energy and motivation and I gained 5 lbs in a week at one point. I finally found a doctor who would listen and they put me on a low dose of thyroid meds. It's made the world of difference.

The anger is still there, but no where near the level it used to be. I find that yes, PMS does make it a worse. But I'm prepared for that now so I can work with it.

Stick with it for a bit, take your supplements (I'm on 2 x 100mg B-complex if that helps, a normal supermarket multivitamin won't contain anywhere near that amount). Switch from B6 to B-complex though, B6 alone doesn't work as well, I tried just B6 at first too, it helped a little, but not much. Apparently you need all of the B's, they work in synergy.

I've started taking supplements that are supposed be beneficial for epilepsy too (EPA, Vit E, Magnesium etc) and I've been able to lower my dose back down to 1000 keppra instead of the 1500 I was on before. That's possibly helped too.

Good luck
 
Hi maddie!

I also feel good most of the time, the times when I get angry and low are an exception to the rule. But nevertheless they are getting more and more scary with each successive episode.

You are making a good point about the B complex instead of B6. I will switch to that one when I finish those I have at the moment, which should be pretty soon anyway ;). I will look into other supplements as well!

I am glad to hear that you are happy with this med. Hopefully, I will work out a solution to my problem soon and I won't need to make any drastic med changes because that scares me the most of all.

Good luck for you too :).
 
I'm not sure how happy/not happy I am with it, time will tell. I just can't face another med switch, my last one was hell on earth, so I'm dealing with it :p

It's also hard to tell how much of this improvement is down to thyroid meds, I've suspected my thyroid to be off for over a year now but every doctor kept saying "normal, it's fine" when things really weren't.

Up points:
No more 2 day migraines from the tiniest sip of alcohol. No more migraines at all actually.
Feeling more grounded, less 'emotional' over stupid things. Lamictal made me quite over emotional.

Down points:
Maybe the 'grounded' is bordering on a lack of caring now?
Anger
Bad PMS (hormones are still out of whack from BCP though, working on that)


Oh another supplement that I really believe helped me, Vitamin D. I rarely went out and always wore factor 50 when I did, I probably had zero vit D in my system lol. Taking 5000UI a day of that too seems to have really helped - vit D deficiency can manifest itself as depression
 
I understand what you mean saying that you are not sure whether you are happy or not with this med ;) i'm happy because it is the best medication for my seizures from all i have tried so far. I am not happy because, unlike you, I am now overly emotional, get upset by silly things which wouldn't bother me before. But overall, I am prepared to deal with some side effects if it means having some control over my life.

It's more complicated in your case not knowing what is actually due to Keppra and what is caused by other meds and thyroid problems. But it's good news that it helps for migraines :). In my case I seem to have more minor headaches than before but this is manageable.
 
I myself was an easy going person at one time. Then I became a complete different person. I would argue and get angry at minor issues. Those are just a couple of things that happened out of so many. No one wanted to be around me. Over time with the changes of meds and studying the side effects we were able to find out why I did changed. Look at the side effects and mention it to the dr. GOOD LUCK!
 
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