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Does High Dose Of Keppra Help Deal With Anxiety?

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Posted on Tue, 2 Sep 2014
Question: I am on Keppra 1000mg (my doctor uses it as mood stabilizer), Amisulpride 100mg, Lexapro 5mg (since one week) ank Klonopin 2 mg. I was before on Lexapro 2.5 mg. My psychiatrist decided to give a higher dosage of Lexapro because i have anxiety but also some symptoms of OCD. Since antiepileptics help to a better metabolism of meds, i would like to know if a higher dosage of Keppra can help to a better metabolism of Lexapro 5mg. I have to wait a week until a new dosage of Lexapro, probably 7.5 mg, and i can't go on very high dosage because i am a poor metabolizer for cyp2c19 and mild for cyp2d6 (i have also probably rapid acetylation for Klonopin). Can a higher dosage of Keppra help? I would like to discuss this with my psychiatrist. Thanks beforehand.
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Answered by Dr. Dr. Chintan Solanki (3 hours later)
Brief Answer:
No it is not like that

Detailed Answer:
Hi,

Thanks again for question.

You are right that anti epileptics help to better metabolism of some drugs but it is not so for all antiepileptic.

Keppra itself metabolized by enzymatic hydrolysis of the acetamide group not by CyP450 system. Another thing is it is also not inducer of CyP450 system enzyme(like another anti epileptic carbamazapine and valproate), so keppra is not going to effect on metabolism of lexapro.

So higher doses of keppra not help in that way. As lexapro is mainly metabolized by CYP3A4 and CYP2C19, there can be possibility of increase in dose with monitoring as there is no involvement of CYP2D6.

You can discuss now to your doctor with this information.

I will glad to help further if needed.

Thanks & regards,
Dr. Chintan Solanki.
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Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2407 Questions

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Does High Dose Of Keppra Help Deal With Anxiety?

Brief Answer: No it is not like that Detailed Answer: Hi, Thanks again for question. You are right that anti epileptics help to better metabolism of some drugs but it is not so for all antiepileptic. Keppra itself metabolized by enzymatic hydrolysis of the acetamide group not by CyP450 system. Another thing is it is also not inducer of CyP450 system enzyme(like another anti epileptic carbamazapine and valproate), so keppra is not going to effect on metabolism of lexapro. So higher doses of keppra not help in that way. As lexapro is mainly metabolized by CYP3A4 and CYP2C19, there can be possibility of increase in dose with monitoring as there is no involvement of CYP2D6. You can discuss now to your doctor with this information. I will glad to help further if needed. Thanks & regards, Dr. Chintan Solanki.