Brivaracetam as adjunctive therapy for the treatment of partial-onset seizures in patients with epilepsy: the current evidence base.

Brivaracetam (BRV) is a novel antiepileptic drug recently licensed for the treatment of partial epilepsy in adults and adolescents over 16 years old. Like levetiracetam (LEV), it is a ligand of the synaptic vesicle protein SV2A. BRV has been shown in animal models and in studies using human brain slices to have a higher SV2A affinity and faster penetration into the brain. Its efficacy and safety have been shown in several randomized, controlled studies. The recommended initial dose is 50-100 mg, divided into two daily doses. Up-titration to a 200 mg daily dose is possible. Dizziness and somnolence are frequent side effects. There are some hints that BRV may be less frequently associated with behavioural adverse events than LEV. Long-term efficacy and safety and BRV use in special patient groups have to be assessed in the future.