Jerry J Shih: Brivaracetam and Levetiracetam for Seizures



Brivaracetam is one of the newest anti-seizure drugs that was approved by the Food and Drug Administration, and as such, there's a tremendous amount of interest regarding Brivaracetam.

Brivaracetam is actually a unique compound. It's one of those compounds that actually targets a type of protein or type of vesicle called the SV2 which is on the presynaptic terminus.

It's a cousin if you will, or it's structurally related to a drug that we use fairly commonly now called levetiracetam, or the brand name is Keppra.

It's been out for you know over 15 years, and been a very effective anti-seizure drug. But one of the main problems with the use of this drug levetiracetam or Keppra is that in about one in five - one in six people have mood issues. They're irritable, they're grouchy and you know that's complicated in the sense that if your seizures are well controlled, but you're then — it's something that you know is a problem and alters quality of life so it happens to one in five - one in six people. So it's not uncommon for that to happen to levetiracetam.

Brivaracetam this newer drug is felt to potentially have less mood side effects. So that the potential for Brivaracetam is that maybe it has the effectiveness of the levetiracetam that's already approved, but it may not have some of the side effect profile, so that's the hope and the goal it's been out for you know a little over a year, year and a half, so we don't have as much experience with it.

I think time will tell where Brivaracetam fits in terms of our armamentarium of anti-seizure drugs that we use. As you may know there are over 18, 19 drugs that are available by prescription here in the United States to treat seizures, so it's going to take a little bit of time us to sort of figure out where Brivaracetam fits on that spectrum but I think it's very promising.

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