Moderate
Alprazolam × Levetiracetam
Benzodiazepines. Short-to-medium-acting anxiolytics×Antiepileptics (other)
Mechanism
Additive CNS depression and sedation. No direct pharmacokinetic interaction – levetiracetam is not CYP-metabolised.
Symptoms
Drowsiness, sedation, ataxia. Older patients: fall risk.
Management
The combination is acceptable when anticonvulsant and anxiolytic therapy are both needed. In older patients, monitor cognition and fall risk. Alternative anxiolytic with minimal sedation: a gabapentinoid (low-dose pregabalin) for anxiety.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.