Levetiracetam (Keppra) and Ketamine Therapy | Tovani Health
Keppra (Levetiracetam) — Anticonvulsant (SV2A modulator)
Verdict at Tovani Health
Compatible; the mood/irritability side effects are what we screen for upfront.
Levetiracetam and ketamine are compatible. There is no relevant pharmacokinetic interaction (Keppra is renally cleared, not CYP-metabolized). The thing we screen for: Keppra carries a well-known mood and irritability side effect (sometimes called Keppra rage) which we want to baseline before starting KAP.
If you take Keppra regularly and are considering at-home ketamine therapy, the combination is safe with monitoring or dose adjustment. This page covers the brief pharmacologic context and what we do at intake.
How Keppra interacts with ketamine
Levetiracetam modulates synaptic vesicle protein SV2A. No CYP metabolism. No meaningful overlap with ketamine pharmacology.
What we do at intake
Disclose dose and indication. If you have noticed irritability or mood changes on Keppra, mention it during intake.
Bottom line
Levetiracetam and ketamine are compatible. There is no relevant pharmacokinetic interaction (Keppra is renally cleared, not CYP-metabolized). The thing we screen for: Keppra carries a well-known mood and irritability side effect (sometimes called Keppra rage) which we want to baseline before starting KAP.
Frequently Asked Questions
Does Keppra reduce ketamine's antidepressant effect?
No clear signal. Unlike valproate or benzodiazepines, levetiracetam does not have a GABAergic blunting profile.
Ready to find out if at-home ketamine fits your situation?
We’ll note that you’re on Keppra (Levetiracetam) at intake. The eligibility check takes 5 minutes and gives you an honest answer about whether at-home ketamine fits your specific situation.
FL and NJ residents only. Benjamin Soffer, DO — Tovani Health.
Sources
The verdict and clinical guidance on this page are based on the following peer-reviewed literature and FDA prescribing information.
- Ketamine: Pro or antiepileptic agent? A systematic review. Shehata IM, et al.. Heliyon. 2024. PMID: 38293492
Systematic review of ketamine's seizure-modulating effects (mostly antiepileptic in standard doses).
- Ketamine: A Review of Clinical Pharmacokinetics and Pharmacodynamics in Anesthesia and Pain Therapy. Peltoniemi MA, Hagelberg NM, Olkkola KT, Saari TI.. Clinical Pharmacokinetics. 2016. PMID: 27028535
Comprehensive clinical pharmacokinetics/pharmacodynamics review of ketamine including CYP-mediated drug interactions (CYP3A4, CYP2B6).
Clinically reviewed
Reviewed by Benjamin Soffer, DO on May 16, 2026. Dr. Soffer is a board-certified physician (American Board of Internal Medicine) licensed in Florida and New Jersey, prescribing at-home ketamine therapy through Tovani Health.
This page is general information about how this medication interacts with at-home ketamine therapy at Tovani Health. It is not a substitute for medical advice from your prescribing physician about your specific situation. Always discuss medication changes with the doctor who prescribed them.