The 52-year-old has had his bail revoked, days after a reported drug overdose.
He was arrested on Monday after emergency services responded to an incident at a home in Sydney's eastern suburbs on Saturday.
O'Keefe was charged with drug possession after police searched a nearby car and allegedly found methamphetamine.
A magistrate said keeping Andrew O'Keefe in custody was best if he wants to stay alive. (Mick Tsikas/AAP PHOTOS)
Magistrate Jacqueline Milledge said O'Keefe was "lucky to be alive" as she read a police statement of facts on an application to detain the former Network Seven host in Waverley Local Court on Tuesday.
O'Keefe was on bail after allegedly breaching a court order, trespassing and intimidating a man in Sydney's eastern suburbs in July.
O'Keefe's lawyer did not argue against the application and the magistrate revoked his bail, keeping O'Keefe in custody to return to court in October.
"If he wants to stay alive that's the best thing to do," Ms Milledge said.
O'Keefe's lawyer suggested a possible application for release on the next occasion for O'Keefe to receive treatment but Ms Milledge said "a "highly persuasive" argument would be required.
O'Keefe's frequent appearances in court are "absolutely tragic" and "very, very sad," the magistrate said.
"He's a frequent flyer, he's just so used to it," she said.
"The mental health applications, the rehab, all been tried, and tested, and failed.
"I just don't see the same thing over and over again is going to be working for him, and god help him, it's a shame that he doesn't have an epiphany."
O'Keefe was a Seven presenter for more than 15 years, most notably hosting game show Deal or No Deal and breakfast show Weekend Sunrise.
He was convicted of domestic violence offences in January and had an appeal dismissed earlier in September.
An appeal against other drug possession charges was upheld and the conviction quashed.
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