TL;DR: I think Keppra makes me dehydrated because alcohol makes me feel super-dehydrated even if I follow the 2:1 water:alcohol ratio, and because I seem to have a hard time staying hydrated in general. But I'm seeing little if any literature to support dehydration as a Keppra side effect. Does anyone else have any ideas? I posted this in the General Health forum a while back and someone said maybe it's an alcohol allergy, but I don't think so because I don't get most of those symptoms, and it wouldn't explain a lot of what I describe below.
Starting around two years ago, I noticed that alcohol doesn't get me drunk, or even tipsy -- it just gives me body aches, headaches and fatigue. There's no lowered inhibitions or warm, fuzzy sense of well-being or any of the other things people want from drinking. No matter how small or large the amount. At first I thought this a side effect of the anticonvulsant I take (Keppra) -- the instructions say to avoid alcohol because very serious interactions can occur, although they never specify what those interactions are.
A couple medical professionals I talked to about it said that it's because Keppra increases the level of enzymes present in my liver, thereby speeding up my liver's metabolic rate. So my body just skips the drunkenness stage altogether.
But a month and a half ago I started seeing a new neurologist, who said that this is neither a Keppra thing nor an epilepsy thing, and in fact, he has no idea what it's about. And that Keppra is processed through the kidneys, not the liver. So I'm back to the drawing board.
And two neurologists now have told me it's okay to drink, provided that I never get drunk (because that does lower your seizure threshold). And as previously stated, alcohol doesn't get me drunk anymore anyway.
My current neurologist said that I if I do drink, I need to precede and follow every alcoholic drink with a non-alcoholic one. Drinking water and alcohol in a 2:1 ratio was already standard next-day hangover prevention procedure for me when I started noticing these symptoms, and yeah -- it hasn't been enough at all. It takes more like a whole day's worth of water for me to not be in pain from one alcoholic drink.