Does Keppra Help In Treating OCD?

Posted on Thu, 15 Jan 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 15 Jan 2015 Answered on

Mon, 2 Feb 2015 Last reviewed on

Question : I am on Klonopin 2 mg, Lexapro 50 mg, Keppra 1250 mg and Solian (amisulpride) 100 mg for OCD symproms created by Solian and its effects in 5HT7 and 5HT2b receptors and dopaminergic activity. I feel improvement ( between 80 % and sometimes 90%), but not a full one. I would like to know if Keppra can help to avoid OCD symptoms or if, on the contrary, Keppra can cause some OCD symptoms. Thanks beforehand XXXXXXX

Answered by Dr. Dr. Chintan Solanki (1 hour later)

Brief Answer:
Keppra may cause obsessive-compulsive behavior

Detailed Answer:
Hello XXXXXXX

Thanks for writing back.

Keppra is not at all indicated for OCD treatment.

For your question I thought clinically as well as checked evidence based results.

There are no studies which can promptly tell the effects of keppra on OCD.

Few case reports found out suggesting that keppra can cause obsessive-compulsive behavior as a side effect while given for treatment of epilepsy particularly in children.

Some patients have posted that keppra has helped in their OCD. But I checked that they are on other medicines also like lexapro and fluvoxamine simultaneously.

So as a clinician my conclusion is, Keppra is not going to help to avoid OCD symptoms. It may cause no effect on OCD or it may worsen OCD.

Hope I have answered your query,

regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Dr. Chintan Solanki (2 hours later)

Dear Doctor Solanki,
Thank you very much for your clear answer.
Just another question, then. Could Keppra have an effect on dopaminergic activity of amisulpride when this one is taken at low dosage? XXXXXXX

Answered by Dr. Dr. Chintan Solanki (7 hours later)

Brief Answer:
Yes keppra may have an effect on dopaminergic acitivity of amisulpride

Detailed Answer:
Hello,
XXXXXXX

Thanks for very good technical question.

The information you want is very much complicated as mechanism of drugs occur at molecular level and exact mechanism of action of keppra is not established.

However I compared mechanism of action of two drugs.

Keppra binds to a synaptic vesicle glycoprotein, SV2A and inhibits presynaptic calcium channels reducing neurotransmitter release and acting as a neuromodulator. Considering this action keppra might reduce dopamine release.

Amisulpride binds selectively to dopamine D(2) and D(3) receptors in the limbic system. Low doses of amisulpride preferentially block presynaptic D(2)/D(3)-dopamine autoreceptors, thereby enhancing dopaminergic transmission.

From above information possibility is there (only assumption, no practical evidence is there)that Keppra have an effect (opposite to amisulpride) on dopaminergic activity of amisulpride when amisulrpide is taken at low dosage.

Hope you will find the answer helpful.

Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj