Briviact vs Keppra: Battle of the Antiepileptic Titans

Here we will discuss the differences between Briviact vs Keppra, the foremost antiepileptic drugs. The main difference between Briviact and Keppra lies in their selectivity to the synaptic vesicle protein 2A (SV2A) in the brain, with Briviact exhibiting a more targeted binding profile, potentially leading to improved efficacy and tolerability compared to Keppra.

Epilepsy is a neurological disorder that affects millions of people worldwide, and the primary treatment for managing seizures is through antiepileptic drugs (AEDs). In this article, we will delve into the comparison between two commonly prescribed AEDs – Briviact and Keppra. This comparison will help shed light on their similarities, differences, mechanisms of action, efficacy, side effects, dosage, and other relevant factors.

Understanding Epilepsy

Before delving into the comparison, it is essential to have a solid grasp of epilepsy as a medical condition. Epilepsy is a chronic neurological disorder characterized by recurrent and unprovoked seizures. These seizures result from abnormal electrical activity in the brain, leading to various physical and psychological manifestations. There are different types of seizures, and they can vary in severity and frequency from one person to another. Antiepileptic drugs play a crucial role in managing epilepsy by controlling and preventing seizures. Briviact and Keppra are among the medications prescribed to individuals with epilepsy to achieve seizure control and improve their quality of life.

Briviact vs Keppra: Mechanism of Action and Uses


Briviact, also known by its generic name Brivaracetam, is an antiepileptic drug that received FDA approval in 2016. Its mechanism of action involves binding to synaptic vesicle protein 2A (SV2A) in the brain. SV2A is an integral part of neurotransmitter release, and by modulating its function, Briviact helps stabilize neuronal activity and reduce the occurrence of seizures. Briviact is primarily used as an adjunctive therapy for treating partial-onset seizures in patients aged 16 years and older. The medication’s efficacy and tolerability profile have made it a valuable addition to the range of available AEDs.


Keppra, also known as Levetiracetam, is another widely prescribed antiepileptic drug with an established track record in epilepsy management. Similar to Briviact, Keppra’s mechanism of action is also believed to involve binding to SV2A, although its precise mode of action remains not entirely understood. Keppra is indicated for various types of seizures, including partial-onset seizures, myoclonic seizures, and primary generalized tonic-clonic seizures, making it a versatile option for both adults and children.

Briviact vs Keppra: Efficacy

Evaluating the efficacy of Briviact and Keppra is crucial for determining their suitability for individual patients. Clinical studies have demonstrated that both medications effectively reduce seizure frequency and improve seizure control. However, individual responses to AEDs can vary significantly, and factors such as the patient’s age, seizure type, and medical history must be considered when selecting the most appropriate medication. Healthcare professionals should engage in comprehensive discussions with patients to set realistic treatment goals and expectations while optimizing the management of epilepsy.

Side Effects: Briviact vs Keppra

Briviact (Brivaracetam):

  • Drowsiness: One of the common side effects of Briviact is drowsiness or feeling excessively sleepy. Patients may experience reduced alertness, making activities such as driving or operating heavy machinery risky.
  • Dizziness: Briviact can cause dizziness, which may lead to a feeling of lightheadedness or imbalance. Patients should be cautious when changing positions rapidly to avoid falls.
  • Headache: Some individuals may experience headaches as a side effect of Briviact. If the headaches become severe or persistent, it’s essential to inform the healthcare provider.
  • Nausea: Briviact can occasionally cause nausea or a feeling of queasiness. This side effect is usually mild, but it’s essential to stay hydrated and report any severe or persistent symptoms.
  • Fatigue: Patients may feel tired or fatigued while taking Briviact. This side effect may affect daily activities, and adequate rest may be necessary.
  • Mood Changes: Some individuals may experience mood swings, irritability, or changes in behavior while on Briviact. If significant mood changes occur, it’s crucial to inform the healthcare provider.

Keppra (Levetiracetam)

  • Irritability and Aggression: Keppra can sometimes cause irritability, mood changes, or increased aggression in certain individuals. It’s essential to monitor mood closely, especially in patients with a history of psychiatric disorders.
  • Weakness and Fatigue: Some patients may experience weakness or fatigue while taking Keppra. It’s important to balance activities with adequate rest to manage this side effect.
  • Coordination Difficulties: Keppra may affect motor coordination in some individuals, leading to difficulty in performing precise movements.
  • Digestive Upset: Like Briviact, Keppra can also cause nausea and other digestive discomforts, though they are typically mild and transient.
  • Sleep Disturbances: Some patients may experience sleep disturbances, such as insomnia or disrupted sleep patterns, while on Keppra.
  • Skin Rashes: Although rare, Keppra may cause skin rashes in some individuals. Any skin reactions should be promptly reported to the healthcare provider.

Both Briviact and Keppra are generally well-tolerated by most patients. However, individual responses can vary, and it’s essential for patients to communicate any side effects they experience to their healthcare providers.

Briviact vs Keppra: Interactions with other Drugs

As AEDs, both Briviact and Keppra can interact with other medications a patient may be taking. These drug interactions can impact the effectiveness and safety of the AEDs. Pharmacists play a crucial role in reviewing patients’ complete medication profiles to identify potential interactions and avoid adverse outcomes. Adjustments to dosages or alternative treatment options may be necessary to ensure optimal seizure control while minimizing the risk of drug interactions.

Briviact vs Keppra: Dosage and Administration

Accurate dosing and appropriate administration of Briviact and Keppra are critical to achieving optimal treatment outcomes. The dosages of these medications are influenced by factors such as the patient’s age, weight, medical condition, and response to treatment. It is essential for healthcare professionals, including pharmacists, to provide clear instructions on how to take the medications and follow up with patients to monitor their response to treatment. Regular reviews of the dosing regimen may be necessary to adapt to changes in the patient’s condition or medication needs.

Briviact vs Keppra: Cost Considerations

Cost can be a significant factor in the decision-making process for patients and healthcare professionals alike. Briviact, being a relatively newer drug, may be more expensive compared to Keppra, which has a generic version available. Per unit price of Keppra is around $10 while for Briviact, it goes as high as $25. Discussing the cost implications with the patient and exploring options such as insurance coverage or patient assistance programs can be valuable in ensuring access to the most suitable medication.

Patient Preference and Compliance

Patient preference and compliance are vital components of successful epilepsy management. Healthcare professionals must consider patient preferences when recommending an AED, including factors such as dosing frequency and ease of administration. Patients who feel comfortable with their treatment are more likely to adhere to the medication regimen and achieve better seizure control. Pharmacists can play a significant role in educating patients about the importance of medication adherence and addressing any barriers to compliance that may arise.

Briviact vs Keppra: Special Populations

Certain patient populations, such as pregnant women or the elderly, require special consideration when choosing between Briviact and Keppra. Pregnancy introduces unique challenges for epilepsy management, as some AEDs may pose risks of birth defects or complications during pregnancy. The decision to continue or switch medications should involve a collaborative effort between the patient, obstetrician, and neurologist to balance the risks and benefits effectively. Elderly patients may have different tolerability profiles and medication needs, warranting personalized treatment plans to ensure their safety and well-being.

Switching Between Briviact or Keppra

Switching between AEDs may become necessary for various reasons, including inadequate seizure control or intolerable side effects. Healthcare professionals must be knowledgeable about the appropriate procedures for transitioning between Briviact and Keppra. A gradual tapering off one medication while introducing the other can help prevent breakthrough seizures and minimize potential complications during the switch. Regular monitoring and follow-up are essential during this process to ensure a seamless transition and optimize treatment outcomes.

Briviact vs Keppra: Monitoring and Follow-Up

Regular monitoring and follow-up are crucial for patients taking Briviact or Keppra. As healthcare professionals, including pharmacists, ongoing assessment of medication efficacy, side effects, and treatment goals is necessary. Monitoring may include reviewing seizure diaries, conducting medication reviews, and engaging in open communication with patients. This collaborative approach allows for timely adjustments to the treatment plan, improving patient outcomes and overall quality of life.


In conclusion, Briviact and Keppra are both valuable options for managing epilepsy and reducing seizure frequency. They have similar mechanisms of action but may differ in terms of side effects, dosing, and cost. As a human and pharmacist, your expertise in assessing each patient’s unique needs is instrumental in determining the most suitable medication. Working closely with the healthcare team and the patient, you can help achieve optimal seizure control and improve the patient’s overall quality of life.



Why is Brivaracetam better than Levetiracetam?

Brivaracetam and Levetiracetam are both effective antiepileptic drugs, but individual responses can vary. Some patients may find Brivaracetam more effective in reducing seizure frequency and experiencing fewer side effects compared to Levetiracetam. However, the choice between the two medications should be based on the patient’s medical history, seizure type, and response to treatment, and it is essential to work closely with a healthcare professional to determine the most suitable option for each individual.

Why is Briviact a controlled substance, but Keppra is not?

The designation of a controlled substance is determined by government regulations and varies from country to country. The decision to classify a medication as a controlled substance is based on factors such as its potential for abuse and dependence. While Briviact may be classified as a controlled substance in some regions due to its chemical structure, Keppra is not generally considered a controlled substance.

What is the difference between Levetiracetam and Brivaracetam?

Levetiracetam and Brivaracetam are both antiepileptic drugs that act on the synaptic vesicle protein 2A (SV2A) in the brain. However, Brivaracetam has a more selective binding profile to SV2A, which some studies suggest may result in improved efficacy and tolerability compared to Levetiracetam. Additionally, Brivaracetam has a faster onset of action, making it a promising option for patients requiring rapid seizure control.

Is Briviact a good seizure medication?

Briviact has demonstrated efficacy in reducing seizure frequency and is considered a valuable option for managing epilepsy. As with any medication, individual responses can vary, and some patients may find Briviact to be an effective and well-tolerated seizure medication.

What is the most effective seizure medication?

The most effective seizure medication varies from person to person and depends on factors such as the type of seizures, medical history, and response to treatment. Different antiepileptic drugs, including Briviact, Keppra, and others, can be effective in controlling seizures, and the choice of medication should be tailored to the individual patient’s needs.

What type of seizures does Briviact treat?

Briviact is primarily indicated for the treatment of partial-onset seizures in patients aged 16 years and older. It is used as an adjunctive therapy, meaning it is prescribed in combination with other antiepileptic drugs to achieve optimal seizure control.

Does Briviact cause weight gain?

Weight gain is not a common side effect associated with Briviact. However, individual responses to medications can vary, and some patients may experience changes in weight as a result of factors unrelated to the medication. If weight changes are a concern, it is essential to discuss them with a healthcare professional.

What should I avoid while taking Briviact?

While taking Briviact, it is advisable to avoid alcohol and other substances that can potentially interact with the medication or affect its efficacy. It’s also crucial to follow the healthcare professional’s advice regarding activities that require full alertness, especially during the initial phase of treatment when drowsiness or dizziness may occur.

Does Briviact cause anxiety?

Anxiety is not a commonly reported side effect of Briviact. However, as with any medication, individual responses can vary, and some patients may experience mood changes or anxiety. It is essential to communicate any concerning symptoms to a healthcare professional for appropriate evaluation and management.

What is the new drug like Keppra?

There may be newer antiepileptic drugs available or in development with similar mechanisms of action to Keppra (Levetiracetam). Healthcare professionals can stay updated with the latest developments in epilepsy treatment to explore newer options that may offer improved efficacy and tolerability.

Is Brivaracetam better than Levetiracetam for epilepsy?

The comparative effectiveness of Brivaracetam and Levetiracetam in epilepsy management depends on individual patient characteristics and needs. Both medications have shown efficacy in reducing seizures, but individual responses can vary. A healthcare professional can assess the patient’s medical history and response to previous treatments to determine the most suitable option.

What are the side effects of the drug Briviact?

Common side effects of Briviact include drowsiness, dizziness, headache, nausea, fatigue, and mood changes. However, not all patients will experience these side effects, and many individuals tolerate the medication well. It is crucial to monitor for any adverse reactions and report them to a healthcare professional promptly.

What is the safest antiepileptic drug?

The safety of an antiepileptic drug depends on several factors, including the patient’s medical history, potential for drug interactions, and individual tolerability. Some antiepileptic drugs, such as Keppra, have a well-established safety profile, but the safety of any medication should be assessed on a case-by-case basis.

What is the most commonly prescribed drug for epilepsy?

Levetiracetam (Keppra) is one of the most commonly prescribed antiepileptic drugs for epilepsy due to its efficacy and tolerability. It has become a widely used option for various types of seizures in both adults and children.

What does Briviact do to the brain?

Briviact works by targeting the synaptic vesicle protein 2A (SV2A) in the brain. By modulating SV2A, Briviact stabilizes neuronal activity and reduces the occurrence of seizures, helping to manage epilepsy effectively.


  • Centers for Disease Control and Prevention (CDC) (
  • National Institutes of Health (NIH) (
  • PubMed (

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