Brivaracetam for add-on treatment in focal epilepsy

• Published in: Nervenarzt 2016-10, Vol.87 (10), p.1086-1093
• Main Authors: Strzelczyk, A, Steinig, I, Klein, K M, Willems, L M, Knake, S, Rosenow, F, Bauer, S
• Format: Article
• Language: ger
• Subjects: Anticonvulsants - administration & dosage; Anticonvulsants - adverse effects; Chemotherapy, Adjuvant; Disorders of Excessive Somnolence - chemically induced; Disorders of Excessive Somnolence - prevention & control; Dizziness - chemically induced; Dizziness - prevention & control; Dose-Response Relationship, Drug; Epilepsies, Partial - diagnosis; Epilepsies, Partial - drug therapy; Evidence-Based Medicine; Fatigue - chemically induced; Fatigue - prevention & control; Humans; Pyrrolidinones - administration & dosage; Pyrrolidinones - adverse effects; Treatment Outcome
• ISSN: 1433-0407
• DOI: 10.1007/s00115-016-0163-4

Brivaracetam is the latest antiepileptic drug to be approved for adjunctive therapy in focal epilepsy and has a high affinity as a SV2A ligand. The aim of this review article is to summarize the data from the pivotal studies in which more than 2000 patients received brivaracetam. A significant median reduction in seizures from 30.5 % to 53.1 % for 50 mg/day, from 32.5 % to 37.2 % for 100 mg/day and 35.6 % for 200 mg/day could be demonstrated. Overall brivaracetam appears to be well-tolerated, with fatigue, dizziness and somnolence being the main adverse side effects. An immediate change from levetiracetam to brivaracetam at a conversion ratio of 10:1 to 15:1 seems feasible and could alleviate behavioral side effects related to treatment with levetiracetam. A swift permeability into brain tissue and a faster onset of action compared to levetiracetam suggest that brivaracetam could be useful in emergency situations.