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There has been very little good news when it comes to preventing or treating Alzheimer’s disease. Billions have been spent on drug development but there is little, if anything, to show for the effort.

A new study from Johns Hopkins University (Neurolmage: Clinical, online, Feb. 21, 2015) may have discovered an exciting new use for an old drug. Keppra was first approved as an anticonvulsant to treat epilepsy in 2000. In 2008 it became available generically as levetiracetam. That makes the drug quite affordable, though we have received a number of reports from patients that some generic formulations may not work as well as brand name Keppra for preventing seizures.

Now, researchers are reporting that this medication may calm over-activity in parts of the brain that may be responsible for mild cognitive impairment and memory problems. Basically we’re talking about brain fog. When the part of the brain called the hippocampus becomes overactive, it may portend increased deterioration in thinking and memory and eventually lead to full-blown Alzheimer’s disease.

The Study

The investigators employed the gold standard format, a randomized, double-blind, placebo-controlled study to test the effects of levetiracetam on the brain. They analyzed data from 54 participants who had been diagnosed with pre-dementia memory loss. They defined these patients as having “amnestic mild cognitive impairment” or aMCI. The remaining 17 volunteers were healthy with normal brain function.

The subjects were given different doses of levetiracetam, ranging from 62.5 mg twice a day to 125 mg twice a day all the way up to 250 mg twice a day. Subjects had their brain activity assessed in the MRI scanner. They were also tested for memory and cognitive performance.

What Was the Outcome of the Research?

And the envelope please! Both low doses of levetiracetam (62.5 and 125 mg) enhanced memory and normalized the over-activity within the hippocampus. In their own words the researchers reported:

“The primary focus in the current study was to assess the effects of treatment with the atypical anti-epileptic, levetiracetam, on memory performance in the scanning task and fMRI [functional magnetic resonance imaging ] signals in aMCI [amnestic mild cognitive impairment] patients. In the current investigation, low doses of levetiracetam (62.5 and 125 mg BID [twice a day]) significantly improved memory performance in the scanning task with attenuation of overactivity, an effect that was statistically significant at 125 mg BID…The current findings further suggest that in the dose range of 62.5-125 mg BID, levetiracetam confers benefit on the network properties of the medial temporal lobe memory system.”

What makes this research intriguing is that they used very low doses of levetiracetam. A standard dosing regimen for epilepsy would be 500 mg twice daily up to a maximum of 3,000 mg a day. The dose used in this dementia study was one-eighth to one-fourth of the lowest dose used to control seizures.

That creates an interesting challenge for physicians who might want to experiment with this drug. It is only available in 250 mg tablets (or greater strengths). The only way a physician could approximate the dose would be to utilize the oral solution (100 mg/ml) and have a pharmacist make the appropriate dosing adjustments and instruct patients accordingly.

What about side effects?

At the very low doses used in this experiment we suspect that adverse reactions related to levetiracetam were probably mild, but the researchers did not describe complications. That may be in part because the study was so short. Nevertheless, we feel it necessary to let readers know what the potential adverse reactions  of higher doses used to control epilepsy might be.

Levetiracetam Side Effects

  • Fatigue, tiredness, lack of energy
  • Digestive upset (nausea, diarrhea, loss of appetite, vomiting)
  • Changes in behavior (agitation, anxiety, irritability, hostility, confusion, depression)
  • Dizziness, vertigo, unsteadiness
  • Sore throat, sinusitis, runny nose, infection
  • Rash (requires immediate medical attention)
  • Blood disorders

Bottom Line

We are very impressed with this research. It is the first good news we have seen regarding cognitive impairment, memory loss and Alzheimer’s disease in a very long time.

Nevertheless, this is a preliminary study. Since it only lasted a few weeks, it is impossible to know whether the benefits of levetiracetam will persist. Although animal research seems to confirm that the drug should be helpful, larger, longer studies are essential.

There is a problem, though. Levetiracetam is now available generically. That means no drug manufacturer is likely to invest money in a medication that has lost its patent.

The lead investigator, neuroscientist Michela Gallagher, PhD, concludes:

“What we want to discover now, is whether treatment over a longer time will prevent further cognitive decline and delay or stop progression to Alzheimer’s dementia.”

We hope Professor Gallagher will continue her exciting line of research and that other investigators will also join the effort. We are in desperate need of better strategies for preventing and treating this devastating condition. Let’s hope the preliminary findings are confirmed by future research.

The full article can be accessed at this link. Be warned, though. It is written in heavy neuroscientific lingo and is a bit hard to untangle. Nonetheless, we hope other neuroscientists will read this research, keep and open mind and consider testing levetiracetam themselves.

Please share your own thoughts about dementia below and vote at the top of this article.

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  1. Linda
    Denver
    Reply

    My mom has Alzhiemer’s type dementia. She had 2 seizures about a year ago and was put on Keppra, 500 MG 2 times per day. The change in her ability to engage in conversations, remember short term events and overall functioning were remarkable. We thought she was not going to live much longer one year ago. Now we took her on a week’s long vacation and she functioned very well. She still has the disease and struggles but the difference is nothing but amazing.

  2. John
    Oregon
    Reply

    Discontinued levetiraceta 500 mg that was used to prevent diabetic seizures. That was some time ago. my wife now has memory loss and this is an interesting and hopeful development. I plan to restart.

  3. jp
    Iowa
    Reply

    My 90 yr old mother has been on Aricept for over a year. It’s helped but still had some mental cloudiness. Recently wound up in hospital for a brain bleed/burr hole surgery/and put on Keppra to prevent a seizure. She wound up having one so they upped it to 750mg 2x a day. The mental clarity is amazing. She has even commented that she feels so different. We haven’t seen her this good in a long time. Maybe just coincidental with the brain healing from the surgery but we tend to think that the combo of the Aricept and the Keppra has helped.;)

  4. C.
    south
    Reply

    I was so glad and hopeful to see your article “Can Levetireacetam reverse memory Problems Leading to Alzheimer’s?” This gives me hope. My husband’s mother died of that disease. It is so painful to the caregiver. I see signs of its beginning in my husband. This article gives me hope for him. Thank you so much for all the wonderful information you send out each week.

  5. PP
    Florida
    Reply

    We are seeing good results with Namenda, although it is VERY expensive. Aricept was not tolerated in our case. The two drugs work very differently.

  6. BILL P
    CA.
    Reply

    Might this work on essential tremor?
    I now take primadone & it to is a epileptic med.

  7. Anne
    Wisconsin
    Reply

    I know it’s important to keep doing research in this area, especially with our aging population. But the way our money is wasted is extremely frustrating. My 95 year old mother has been on aricept and Nemenda for years. Nemenda is unbelievably expensive! I recently had a chance to talk to a palliative doctor who works at the clinic and consults with the nursing home. We went over the drugs my mom was getting and when he saw these two drugs he told me neither was very helpful. The aricept was something she should have gotten in the early stages of Alzheimer’s and who knows why her regular doctor kept her on it! Now we are going to wean her off both drugs. I’m not counting on it, but he said she might even do better (because of side effects) without them. I’m angry that her regular doctor seems to want to continue drugs that aren’t helpful and I am in the process of finding someone else.

  8. Nita, RN, BSN
    Siler City, NC
    Reply

    Have just started reading about the success of something else that makes me wonder how in the heck they came about with the idea–methylene blue for bipolar disorder and Alzheimer’s. Phase II trials look very promising from the little bit of research I’ve done so far. If you look into it and find material worth sharing, I’d love to know about it. Thanks

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