What is Brivaracetam: Uses, Dosage, Side Effects and More

Brivaracetam is a prescription medication that helps control seizures in people with epilepsy. It's part of a group of medicines called antiepileptic drugs, which work by calming overactive electrical signals in your brain that can trigger seizures.

This medication has been helping people manage their epilepsy since it was approved by the FDA in 2016. While it's a relatively newer option compared to some other seizure medications, it has shown good results in clinical studies and real-world use.

What is Brivaracetam Used For?

Brivaracetam is primarily used to treat partial-onset seizures in adults and children who are at least one month old. Partial-onset seizures are the most common type of seizure, where abnormal electrical activity starts in one specific area of the brain.

Your doctor will typically prescribe brivaracetam as an "add-on" treatment, meaning you'll take it along with other seizure medications you're already using. This combination approach often works better than relying on just one medication alone.

Sometimes, doctors may also prescribe brivaracetam for other types of seizures if they believe it could be helpful for your specific situation. This is called "off-label" use, and it's a common and accepted practice in medicine when doctors have good reasons to believe a medication might help.

How Does Brivaracetam Work?

Brivaracetam works by binding to a specific protein in your brain called SV2A, which helps control how nerve cells communicate with each other. When seizures happen, nerve cells in your brain fire too rapidly and in an uncontrolled way.

By attaching to these SV2A proteins, brivaracetam helps slow down this overactive communication between nerve cells. Think of it like a traffic controller helping to manage the flow of electrical signals in your brain, preventing the traffic jams that can lead to seizures.

This medication is considered moderately strong in terms of seizure control. It's not the strongest option available, but it's definitely effective for many people. What makes it particularly useful is that it tends to work well with other seizure medications without causing too many problematic interactions.

How Should I Take Brivaracetam?

You can take brivaracetam either with food or without food - it doesn't matter for how well the medication works. However, taking it with food might help reduce any stomach upset you might experience when you first start the medication.

The tablets should be swallowed whole with water or another liquid. Don't crush, chew, or break the tablets, as this can affect how the medication is released in your body. If you have trouble swallowing tablets, talk to your doctor about whether there might be other options for you.

It's best to take brivaracetam at the same times each day to keep steady levels of the medication in your system. Many people find it helpful to link taking their medication to daily routines, like brushing their teeth or eating meals.

If you're taking the oral solution form, use the measuring device that comes with the medication to ensure you're getting the right dose. Regular household spoons aren't accurate enough for measuring liquid medications.

How Long Should I Take Brivaracetam For?

Most people with epilepsy need to take brivaracetam long-term to keep their seizures well-controlled. This typically means taking it for years, and sometimes for life, depending on your specific type of epilepsy and how well you respond to treatment.

Your doctor will usually start you on a lower dose and gradually increase it over several weeks to find the right amount for you. This process, called titration, helps minimize side effects while finding the most effective dose for your seizure control.

After you've been seizure-free for a certain period - usually at least two years - your doctor might discuss the possibility of slowly reducing your medication. However, this decision depends on many factors including your type of epilepsy, your EEG results, and your overall health situation.

Never stop taking brivaracetam suddenly, even if you're feeling well and haven't had seizures. Stopping seizure medications abruptly can actually trigger more seizures, including potentially dangerous ones. Always work with your doctor to make any changes to your medication routine.

What Are the Side Effects of Brivaracetam?

Like all medications, brivaracetam can cause side effects, though not everyone experiences them. Most side effects are mild to moderate and often improve as your body adjusts to the medication over the first few weeks.

The most common side effects you might experience include feeling drowsy or tired, especially when you first start taking the medication. Here are the side effects that affect people most frequently:

• Drowsiness or fatigue
• Dizziness
• Nausea
• Headache
• Feeling irritable or agitated
• Problems with coordination or balance

These common side effects usually become less bothersome as your body gets used to the medication. If they persist or interfere with your daily activities, let your doctor know - they might adjust your dose or suggest ways to manage them.

Some people may experience more concerning side effects that require immediate medical attention. These are less common but important to recognize:

• Severe mood changes or depression
• Thoughts of harming yourself
• Severe allergic reactions with rash, difficulty breathing, or swelling
• Severe dizziness or fainting
• Unusual changes in behavior or thinking

If you experience any of these more serious side effects, contact your doctor right away or seek emergency medical care if the symptoms are severe.

Who Should Not Take Brivaracetam?

While brivaracetam is generally safe for most people, there are certain situations where it might not be the right choice. Your doctor will carefully consider your medical history before prescribing this medication.

People who are allergic to brivaracetam or any of its ingredients should not take this medication. If you've had allergic reactions to other seizure medications, make sure to tell your doctor about this history.

Special caution is needed for people with certain medical conditions. Your doctor will need to monitor you more closely if you have:

• History of depression or other mental health conditions
• Kidney problems
• Liver disease
• History of suicidal thoughts or behaviors

If you're pregnant or planning to become pregnant, discuss this with your doctor. While brivaracetam may be necessary for seizure control during pregnancy, your doctor will want to carefully weigh the benefits and risks for both you and your baby.

Breastfeeding mothers should also talk with their doctor, as small amounts of brivaracetam can pass into breast milk. Your doctor can help you make the best decision for your situation.

Brivaracetam Brand Names

Brivaracetam is sold under the brand name Briviact in the United States and many other countries. This is the most common way you'll see it prescribed and labeled at the pharmacy.

The medication is manufactured by UCB, a pharmaceutical company that specializes in neurological conditions. Whether you receive the brand name or a generic version, the active ingredient and effectiveness should be the same.

When picking up your prescription, always double-check with your pharmacist that you're receiving the correct medication. If the pills look different from what you're used to, don't hesitate to ask - sometimes pharmacies switch between different manufacturers of the same medication.

Brivaracetam Alternatives

If brivaracetam isn't working well for you or is causing problematic side effects, there are several other seizure medications your doctor might consider. The choice of alternative depends on your specific type of epilepsy and how you've responded to other treatments.

Some commonly used alternatives for partial-onset seizures include levetiracetam (Keppra), lamotrigine (Lamictal), and oxcarbazepine (Trileptal). Each of these medications works differently in the brain, so one might be more effective for you than another.

Newer options include perampanel (Fycompa), lacosamide (Vimpat), and eslicarbazepine (Aptiom). These medications have been developed more recently and may offer advantages for certain people, especially those who haven't responded well to older medications.

Your doctor will consider many factors when choosing alternatives, including your seizure type, other medications you're taking, potential side effects, and your lifestyle needs. Sometimes, the best approach involves trying different combinations of medications to find what works best for you.

Is Brivaracetam Better Than Levetiracetam?

Both brivaracetam and levetiracetam (Keppra) are effective seizure medications that work on similar pathways in the brain, but they each have their own advantages and disadvantages. There's no single "better" medication - it really depends on how your body responds to each one.

Brivaracetam is actually related to levetiracetam chemically, but it was designed to potentially cause fewer mood-related side effects. Some people who experience irritability, aggression, or mood changes with levetiracetam find that brivaracetam is better tolerated.

Levetiracetam has been around longer and has more extensive research data, especially for use in children and during pregnancy. It's also available in generic form, making it less expensive than brivaracetam for many people.

Studies suggest that both medications are similarly effective for controlling seizures. The choice between them often comes down to side effects, cost, and your individual response. Some people do better with one, while others prefer the other.