Brivaracetam to Treat Partial Onset Seizures in Adults

Author:

Latimer Dustin1,Le David2,Falgoust Evan3,Ingraffia Patrick3,Abd-Elsayed Alaa4,Cornett Elyse M.5,Singh Rupin6,Choi JooHee7,Varrassi Giustino8,Kaye Adam M.9,Kaye Alan D.5,Ganti Latha6

Affiliation:

1. Louisiana State University Health Science Center, Baton Rouge, LA

2. Louisiana State University New Orleans School of Medicine, New Orleans, LA

3. Louisiana State University Shreveport School of Medicine, Shreveport, LA

4. University of Wisconsin School of Medicine and Public Health, Madison, WI

5. Louisiana State University Shreveport, Shreveport, LA

6. University of Central Florida College of Medicine, Orlando, FL and HCA Osceola Hospital, Kissimmee, FL

7. Georgetown University School of Medicine, Washington, DC

8. Paolo Procacci Foundation, Roma, Italy

9. Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA

Abstract

Purpose of Review Seizures are a hyperexcitable, and hypersynchronous imbalance between excitatory and inhibitory factors (E/I imbalance) in neurotransmission, and epilepsy is the recurrent manifestation of seizures within a reasonable time frame and without being attributable to a reversible cause. Brivaracetam is a derivative of the antiepileptic agent, levetiracetam, that is used as adjuvant therapy for focal onset seizures. It was approved by the FDA in 2016 and has shown promising results with minimal adverse effect reactions in clinical trials. Recent Findings Brivaracetam has been used in multiple clinical trials at various dosages in adults that have partial-onset seizures refractory to conventional treatment. A meta-analysis in 2016 showed that brivaracetam as adjunctive therapy was statically significant in its reduction of adults with drug-refractory seizure frequency.1 The most commonly reported adverse effects that patients who were taking brivaracetam experienced were somnolence, headache, and dizziness. Further studies are necessary to conclude long term efficacy and safety profile of brivaracetam. Conclusion The treatment of epilepsy with pharmacologic agents is a difficult task due to balancing the efficacy of the drug with the side effect profile that will allow for the best quality of life for the patient. There are approximately 30 antiepileptic agents for clinicians to choose from. Brivaracetam is a novel antiepileptic agent that was approved for use by the FDA in 2016 and is showing promising results as monotherapy and adjunctive therapy in individuals with drug-refractory focal seizures while minimizing adverse drug reactions.

Publisher

Open Medical Publishing

Reference54 articles.

1. Seizures and Epilepsy: An Overview for Neuroscientists;C. E. Stafstrom;Cold Spring Harbor Perspectives in Medicine,2015

2. Pathophysiology and Definitions of Seizures and Status Epilepticus;J. Stephen Huff;Emergency Medicine Clinics of North America,2011

3. Chronic ethanol administration alters γ-aminobutyric acid, pentobarbital and ethanol-mediated 36Cl- uptake in cerebral cortical synaptoneurosomes;A.L. Morrow;J Pharmacol Exp Ther,1988

4. Effectiveness of Multiple EEGs in Supporting the Diagnosis of Epilepsy: An Operational Curve;Martin Salinsky;Epilepsia,1987

5. Practice parameter: Evaluating an apparent unprovoked first seizure in adults (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society;A. Krumholz;Neurology,2007

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