Levetiracetam

Levetiracetam, sold under the brand name Keppra among others, is an antiepileptic drug (medication) used to treat epilepsy. It is used for partial-onset, myoclonic, or tonic–clonic seizures, and is taken either by mouth as an immediate or extended release formulation or by injection into a vein.

Common side effects of levetiracetam include sleepiness, dizziness, feeling tired, and aggression. Severe side effects may include psychosis, suicide, and allergic reactions such as Stevens–Johnson syndrome or anaphylaxis. Levetiracetam is the S-enantiomer of etiracetam. It acts as a synaptic vesicle glycoprotein 2A (SV2A) ligand.

Levetiracetam was approved for medical use in the United States in 1999 and is available as a generic medication. In 2023, it was the 101st most commonly prescribed medication in the United States, with more than 6 million prescriptions. It is on the World Health Organization's List of Essential Medicines.

Levetiracetam is effective as single-drug treatment for newly diagnosed focal epilepsy in adults. It reduces focal seizures by 50% or more as an add-on medication.

Levetiracetam is effective as add-on treatment for partial (focal) epilepsy.

Levetiracetam is effective for treatment of generalized tonic-clonic epilepsy. It has been approved in the United States as add-on treatment for myoclonic, and tonic-clonic seizures. Levetiracetam has been approved in the European Union as a monotherapy treatment for epilepsy in the case of partial seizures or as an adjunctive therapy for partial, myoclonic, and tonic-clonic seizures.

Levetiracetam is sometimes used off label to treat status epilepticus.

Based on low-quality evidence, levetiracetam is about as effective as phenytoin for prevention of early seizures after traumatic brain injury. It may be effective for prevention of seizures associated with subarachnoid hemorrhages.