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Can Levetiracetam cause dizziness after 4 years of usage?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have been taking Levipil 500 for the past four years, and for the last three years, I have not experienced any side effects with the medication. But, for the past two weeks, I have been feeling dizzy after taking the medicine. My body has seemingly adjusted to the medication. I am wondering why I am now experiencing these side effects. Is there a reason to be concerned?

Thank you.

Answered by Dr. Hitesh Kumar

Hello,

Welcome to icliniq.com.

I read your query and understand your concern.

Experiencing dizziness or sleepiness with Levetiracetam after such a long period is unusual. These side effects are usually more noticeable during the initial phase of treatment. But, in some patients, especially on long-term use, Levetiracetam may lead to mood changes such as depression, mania, or psychosis, which can manifest as feelings of lethargy, weakness, and tiredness.

To gain a clearer understanding of your situation, could you provide the following information:

  1. Have you recently skipped the medication for a few days and then restarted? Your attached prescription (attachment removed to protect the patient's identity) indicates that you had stopped medications several times before.
  2. Has the dose of Levetiracetam been increased recently?
  3. Are you taking any other medications in addition to Levetiracetam?
  4. How would you describe your mood in your day-to-day activities recently?
  5. Are you getting enough good-quality sleep at night, or has this been disrupted in any way?

Kindly revert with the information.

Thank you.

Investigations to be done

Complete blood count. Liver function test. Kidney function test. Thyroid function test.

Preventive measures

1. Observe your symptoms. 2. Try to take medications on regular timings daily. 3. Take proper sleep in night time. 4. Try light exercises / jogging for 20-30 minutes in morning time daily.

Regarding follow up

Review with above mentioned information for better understanding & judgement.

Patient's Query

Hello doctor,

Thank you for providing more information. Here are the responses to your questions:

  1. I did skip my medication for two days last year, which resulted in a seizure. Since then, I have been diligent about taking my medication without any missed doses.
  2. There has been no recent increase in the dosage of my medication.
  3. I am solely taking levetiracetam and not on any other medications.
  4. My mood remains normal, and I haven't experienced any noticeable changes.
  5. My sleep patterns have not been disrupted, but I have been experiencing sleepiness.

Thank you.

Answered by Dr. Hitesh Kumar

Hi,

Welcome back to cliniq.com.

It is challenging to pinpoint the exact cause of your recent dizziness, and whether it is directly linked to Levetiracetam or caused by other factors. It might be a good idea to schedule an in-person consultation with a neurologist for an evaluation of your dizziness. I suggest you consider requesting a serum Levetiracetam level test to assess the concentration of the medication in your bloodstream.

Hope this information helps you.

Thank you.

Investigations to be done

Serum Levetiracetam level

Patient's Query

Hello doctor,

Thank you for your reply.

I have undergone KFT and LFT, and I have attached the reports for your reference. I also had a recent consultation with my neurologist, during which I informed him about my symptoms. He suggested that the dizziness is a side effect of the medication and will eventually subside. However, I am not convinced about this explanation and would like your recommendation regarding additional tests to further investigate the underlying cause. I am planning to have a CBC and a thyroid test done this weekend.

Thank you.

Answered by Dr. Hitesh Kumar

Hello,

Welcome back to icliniq.com.

The attached liver function tests (LFT) and kidney function tests (KFT) reports (attachment removed to protect the patient's identity) are within the normal range. Could you please provide a detailed description of the "dizzy" feeling? What specific symptoms do you experience during these episodes, and how long do they typically last? Also, how frequently do these episodes occur? Have you ever experienced sensations like anxiety, a fast heartbeat, or a choking sensation during these episodes?

Thank you.

Patient's Query

Hi doctor,

I experience dizziness when I am in a seated or resting position. It tends to occur briefly, lasting no longer than a minute, and happens two to three times a day. This dizziness subsides when I become active and engage in any physical activity. During these episodes, I do not encounter any other symptoms such as anxiety, choking sensations, or a fast heartbeat. My heart rate remains within the normal range, and I generally feel energetic without experiencing any feelings of laziness.

Thank you.

Answered by Dr. Hitesh Kumar

Hi,

Welcome back to icliniq.com.

Based on the description, it is challenging to arrive at a definitive conclusion. The absence of symptoms while working makes it less likely to be a side effect of Levetiracetam. It could potentially be related to anxiety or other factors, but I suggest further evaluation by a medical professional to better understand the cause of these symptoms.

Thank you.

Patient's Query

Hi doctor I have done my CBC and thyroid test, please look at it and suggest what is it that is leading to feel dizzy. Attached is the report.
Answered by Dr. Hitesh Kumar
Hello Your blood test reports showing (1) elevated cholesterol & LDL cholesterol (2) LowT3 & T4 with slightly upper border TSH Rest are with in normal range. These results do not conclude any reason for dizziness. Though for these, you need to consult Medicine doctor. And avoid oily & fried foods. Start some exercise program daily.

Patient's Query

Then what is it that is making me feel dizzy and that too right after taking Levipil. My body is not adjusting well with the medicine, may be the dose has to get reduced?? as it has been so long since I am taking the medicine. Can it be the reason for feeling dizzy??
Answered by Dr. Hitesh Kumar
It seems unlikely that medicine is causing it. If you feel that medicine might be causing it, you can plan for "Serum Levetiracetam Level" to check if medicine concentration in your blood is in therapeutic range or high or low. One possibility can be it being psychogenic or mood / anxiety related.

Answered byDr. Hitesh Kumar

Medically reviewed byiCliniq medical review team

Published At January 13, 2024
Reviewed AtJune 13, 2024

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Hitesh Kumar
Dr. Hitesh Kumar

Neurology

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