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Compare Topamax vs. Keppra

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Topiramate (Topamax, Qudexy XR, Trokendi XR, Eprontia) and levetiracetam (Keppra, Keppra XR, Roweepra, Elepsia XR) are both antiepileptic medications used to treat seizures, but they have some key differences. Topiramate can also be used to prevent migraines, while levetiracetam is not indicated for this use. Topiramate is available in both immediate-release and extended-release forms, as well as a liquid, and is typically taken once or twice daily. Levetiracetam also comes in immediate-release and extended-release forms, and it is taken twice daily for the immediate-release and once daily for the extended-release. Topiramate can cause side effects like kidney stones, serious eye problems, and weight loss, whereas levetiracetam can cause mood changes, sleepiness, and headaches. Additionally, topiramate can interact with many other medications, while levetiracetam has no known interactions with food or other medications. Both medications are available in generic forms, making them more affordable options.

Topiramate
Levetiracetam (Keppra)
Topiramate
Levetiracetam (Keppra)
Summary of Topamax vs. Keppra
Summary for Antiepileptic
Prescription only
Topiramate is a prescription medication that can be used alone or in combination with other medications to treat certain types of seizures. It can also be used to prevent migraines. It comes in immediate-release and extended-release tablets and capsules, as well as a liquid. Topiramate is typically taken by mouth once or twice daily, depending on what formulation you're using. Some forms of topiramate are available as lower-cost generic medications.
Summary for Antiepileptic
Prescription only
Immediate-release levetiracetam is a seizure medication for adults and children. It's known as the brand names Keppra and Roweepra, and it also has a generic version. This medication comes as a tablet and liquid that's taken twice each day. The dosage depends on your age, weight, and the type of seizure you have. Levetiracetam (Keppra) doesn't have any known interactions with food or medications. Common side effects include weakness, sleepiness, and headache.
Indications of Topamax vs. Keppra
Indications for

•Seizures (partial seizures, tonic-clonic seizures, Lennox-Gastaut syndrome)

•Migraine prevention

Indications for

•Focal aware (partial-onset) seizures in people ages 1 month and older

•Add-on treatment for myoclonic seizures from juvenile myoclonic epilepsy in people ages 12 years and older

•Add-on treatment for generalized tonic-clonic seizures in people ages 6 years and older
Pros and Cons of Topamax vs. Keppra
Pros and Const for Antiepileptic
Pros

•Can be used on its own or with other medications to control seizures

•Available in short-acting and long-acting forms, so options to take once or twice daily

•Available as a solution (Eprontia), so it's convenient for people who have trouble swallowing

•Can be used to treat different types of seizures

•Can be used to treat seizures in both adults and children

Cons

•Can prevent migraines from happening, but it won't help if you have a migraine attack

•Can cause kidney stones

•Can cause serious eye problems

•Interacts with many medications, such as warfarin (Coumadin), phenytoin (Dilantin), and divalproex (Depakote)

•Children taking this medication for long periods of time will need to have their doses adjusted often due to changes in body weight as they grow

Pros and Const for Antiepileptic
Pros

•Available as tablets and a liquid (liquid recommended for children weighing 44 lbs or less)

•Taken by mouth with or without food

•Usually tolerated well

Cons

•Need to take twice per day

•Might cause changes in behavior or mood

•Might not be the best option if you have a history of mental health problems (e.g., depression, schizophrenia, bipolar disorder)
Common Side Effects of Topamax vs. Keppra
Common Side Effects for
Please note: These are common side effects reported by children and adults who took immediate-release topiramate. Frequency of side effects can differ based on your age, as well as the dose and formulation of topiramate you're taking.

•Feeling "pins and needles"

•Drowsiness

•Weight loss

•Nervousness

•Fatigue

•Dizziness

•Lack of appetite

•Trouble sleeping

•Upper respiratory tract infection (e.g., cough, stuffy nose, sore throat)

•Fever

•Change in taste

•Trouble moving or keeping balance

Common Side Effects for
Side effects were reported by people with focal aware seizures taking levetiracetam (Keppra) with other seizure medications. Side effects might differ for other seizure types. <br> Adults:

•Weakness (15%)

•Sleepiness (15%)

•Headache (14%)

•Infection (13%)

•Dizziness (9%)

Children:

•Headache (19%)

•Common cold symptoms (15%)

•Vomiting (15%)

•Sleepiness (13%)

•Tiredness (11%)

•Being aggressive (10%)

•Cough (9%)

•Stuffy nose (9%)

•Upper stomach pain (9%)

•Lower appetite (8%)
Warnings of Topamax vs. Keppra
Common Side Effects for

•Vision problems

•High body temperature and trouble sweating

•Higher level of acid in blood

•Suicidal thoughts or behavior

•Problems with mood and thinking clearly

•Higher ammonia level in blood

•Serious birth defects

•Skin reactions

•Withdrawal seizures

•Interaction with other medications

Common Side Effects for

•Abnormal mood, thoughts, or behavior

•Suicidal thoughts or behavior

•Difficulty with speech, movement, and concentration

•Serious allergic reactions and skin reactions

•Withdrawal seizures

•Low blood cell counts

•Higher blood pressure in young children

•Seizure control during pregnancy
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Compare Topamax vs. Keppra

Key takeaways

Summary of Topamax vs. Keppra

Indications of Topamax vs. Keppra

Pros and Cons of Topamax vs. Keppra

Common Side Effects of Topamax vs. Keppra

Warnings of Topamax vs. Keppra

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