Levetiracetam and brivaracetam: a review of evidence from clinical trials and clinical experience.

Abstract:

:Until the early 1990s, a limited number of antiepileptic drugs (AEDs) were available. Since then, a large variety of new AEDs have been developed and introduced, several of them offering new modes of action. One of these new AED families is described and reviewed in this article. Levetiracetam (LEV) and brivaracetam (BRV) are pyrrolidone derivate compounds binding at the presynaptic SV2A receptor site and are thus representative of AEDs with a unique mode of action. LEV was extensively investigated in randomized controlled trials and has a very promising efficacy both in focal and generalized epilepsies. Its pharmacokinetic profile is favorable and LEV does not undergo clinically relevant interactions. Adverse reactions comprise mainly asthenia, somnolence, and behavioral symptoms. It has now been established as a first-line antiepileptic drug. BRV has been recently introduced as an adjunct antiepileptic drug in focal epilepsy with a similarly promising pharmacokinetic profile and possibly increased tolerability concerning psychiatric adverse events. This review summarizes the essential preclinical and clinical data of LEV and BRV that is currently available and includes the experiences at a large tertiary referral epilepsy center.

journal_name

Ther Adv Neurol Disord

authors

Steinhoff BJ,Staack AM

doi

10.1177/1756286419873518

subject

Has Abstract

pub_date

2019-09-09 00:00:00

pages

1756286419873518

eissn

1756-2856

issn

1756-2864

pii

10.1177_1756286419873518

journal_volume

12

pub_type

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