Comparative analysis of brivaracetam and levetiracetam in epilepsy treatment

• DOI: 10.4103/etmj.etmj-d-24-00027
• Publication Date: 2025-04-04T10:00:06Z
• Authors: Ming-Yuan Hsu; Shu-Wei Hu; Hueng-Chuen Fan

Abstract Epilepsy affects millions of people worldwide, necessitating effective and safe treatment options. Brivaracetam (BRV) and levetiracetam (LEV) are antiepileptic drugs that target the synaptic vesicle protein 2A (SV2A). Despite the similarities in their chemical structure, BRV and LEV exhibit distinct pharmacological profiles. This study provides a detailed comparative analysis of BRV and LEV, focusing on their mechanisms of action, preclinical profiles, and pharmacokinetic and pharmacodynamic properties. Clinical trial data highlight the efficacy and safety of both drugs, with BRV showing a higher affinity for SV2A and greater potency in certain seizure models. Additionally, emerging treatment strategies and future directions in epilepsy research are discussed, highlighting the potential for BRV and LEV in advancing epilepsy care.