Well the older epilepsy drugs like
tegretol (carbamazepine) have been known to increase cholesterol levels in SOME patients. Additionally,
keppra does not have this claim attached to it so there could be this drop from switching from tegretol to keppra. However, there are very good cholesterol medications to take if the person's level are really that high because in most cases it is not good to switch seizure medication if the one currently being taken (tegretol I assume) is working well. It is better to stop the seizures than risk switching just for 20mg/dl LDL lowering.
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---I answer questions to the best of my ability, but with always limited knowledge of the patient's situation and obviously I can not see your chart or full medical history my advice is limited and should also be confirmed with your own doctor/pharmacist/etc. and I do not promote following my advice without proper approval from your doctor either--
Dr. B
Tegretol vs Keppra 
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