Is Keppra the problem?

July 11, 2011 6:12 PM

My nephew takes Keppra for his epilepsy but I feel the meds caused his severe lack of attention. He was a seemingly alert, outgoing kid before the meds and since he's taken them for 7 years, he's displayed off behavior and his coordination is like a baby's. Is this side effect unique to Keppra or does epilepsy sometimes cause certain learning disabilities?
posted by InterestedInKnowing to Health & Fitness (9 answers total)

A lot of anticonvulsants can cause things like this. See the write-up from the NIH on this particular drug. Side effects can include drowsiness and coordination problems.
posted by rtha at 6:36 PM on July 11, 2011

Check out crazymeds.us -- "A guide to psychiatric medications from first-hand experience, anecdotal evidence and personal research" -- for information on the side effects of Keppra. Note: The site is targeted to adult users of psych meds, so I don't know how much information it will have on how the meds affect kids. (How old is your nephew?)

Re: epilepsy and learning disabilities: I'm at work, so I can't do much research, but I ran across this overview of the topic. I was diagnosed as an adult with ADHD (inattentive type) and with epilepsy. I have certain organizational and executive-function deficits, typical of people w/ADHD, but I was always a strong student as long as I had a structure in place.
posted by virago at 6:37 PM on July 11, 2011

Best answer: Keppra has some side effects that can be consistent with what you are describing, but epilepsy is also associated with changes in cognitive function. A seizure is like a "short circuit" in the electrical activity of the brain. It's a symptom that the neurons in a part or all of the brain are not functioning as they typically do. This can be for a host of reasons, and often it's not totally clear what is causing the seizures. Sometimes whatever is causing the seizures also interferes with typical cognitive functioning (e.g., if there is an injury or lesion in a particular part of the brain, it may cause seizures and may also mean that the functions that usually happen in that part of the brain don't function as efficiently). Seizures themselves can also disrupt attention and other functions. This page (and the website as a whole) has some good information about this. So it is possible that it is either one, or a combination of both. If there are concerns, it is important to talk to his neurologist about what you are observing.
posted by goggie at 7:32 PM on July 11, 2011 [1 favorite]

When I took keppra I never noticed any problems. It was one of the few drugs I took that didn't cause me difficulties. Topamax on the other hand, earned its nickname of dopamax.
posted by St. Alia of the Bunnies at 7:35 PM on July 11, 2011

Epilepsy, depending on where the locus of seizures tends to be, can actually cause certain neurologically based psychological symptoms. Motor coordination, sensory processing, verbal skills, and lots of other things can sometimes be affected based on a particular kid's type/severity of epilepsy. My source for this is that I worked in therapy with a girl with significant autism symptoms but she had epilepsy so I consulted with her neurologist, who specialized in epileptology. He said it's basically hit or miss whether a particular symptom is caused by the epilepsy, the epilepsy mess, or something unrelated to the epilepsy. The only way to tell would be to try changing the mess, but if it alleviates his seizures, then it would really suck to change the mess on him in case the seizures became not-under-control-anymore.
posted by so_gracefully at 7:37 PM on July 11, 2011

(mess was supposed to be meds)
posted by so_gracefully at 7:38 PM on July 11, 2011

I agree with the above comment that both this medication and the underlying condition can lead to the effects you describe. However, I would urge caution in what you do with this information. Is your plan to tell his parents you think his meds are causing this problem? As a parent I can tell you it's often tough to hear people's loving and well-meaning advice, and more often than not, the advice is given without knowledge of the full story or of what I have already researched or tried.

Also, if it's been 7 years, it's pretty hard to know what he would have been like had he not taken the meds (or not had epilepsy). 7 years is a long time in the life of a kid.
posted by serazin at 8:16 PM on July 11, 2011 [2 favorites]

Serazin brings up a good point too. Kids are developing and changing over time and have changing demands made of them. If there is an underlying problem that is present from birth or early in development, it can lead to larger changes in cognition over time as the brain develops in the context of something working differently. The other thing is that children have to carry out more and more demanding skills over time. So we'd expect coordination to look very different in a preschool child vs. a child at school. Kids who are school age or older have more and more demands in terms of paying attention, organizing themselves, planning, etc. as they get older. It's also possible for there to be a problem with some of these things that just doesn't show up as much when a child is younger, simply because they are not expected to do it as part of their day-to-day life.
posted by goggie at 6:15 AM on July 12, 2011

Best answer: We've had good results with a loved one changing from Keppra to Zonisamide. Every case is different. I am not your doctor, and you are not this boy's parent. But there are other good modern anticonvulsants out there. (For adults, you generally want to avoid phenobarbital-- run away fast if your primary care manager mentions it.) Each body has its own unique reactions to various drugs. Perhaps if you couch it as merely a possible alternate medication, instead of an assault on their poor parenting skills for 7+ years, you may find a more receptive audience. Or not. YMMV.
posted by seasparrow at 9:48 AM on July 12, 2011