<s>[INST] Why do nuerologist insist on my daily intake of 500mgs Keppra sustained release and 200 mg Vimpat still 5 years after sucessful brain surgery and no seizures. I experience irritabiltiy, mood swings, below avg body temp and am tired in the day. Also have tendency to cold sores and cancer sores. I do well with the vimpat and would like to continue with Vimpat and have doctore ease me off of the Keppra. Any feedback? [/INST] Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. I would explain that your mood swings could be related to Keppra adverse effects. From the other hand, mood swinging could be also related to brain surgery. Anyway, I would recommend discussing with your doctor on the possibility of stopping gradually Keppra. Hope you will find this answer helpful! Wishing good health, Dr. Iliri </s>