Brivaracetam is a newer antiseizure medication than
levetiracetam. It has a more selective action on the synaptic vesicle
glycoprotein 2A binding site, and it seems to provide a more favorable neuropsychiatric profile. The aim of this study was to assess the safety and tolerability of an overnight switch from
levetiracetam to
brivaracetam. This was a retrospective descriptive study including patients with
epilepsy treated with
levetiracetam, who switched due to inefficacy or previous adverse events (AEs). In total, forty-one patients were included (mean age 40.9 ± 17.8 years, women 48.8%).
Focal epilepsy represented 75.6% (n = 31) of patients (structural cause [n = 25], unknown cause [n = 6]). Four patients had
idiopathic generalized epilepsy, two had developmental and epileptic
encephalopathy and four patients were unclassified. The reason to start
brivaracetam was inefficacy in 53.7% (n = 22), AEs in 65.9% (25/27 neuropsychiatric) and both in 19.5% (n = 8).
Brivaracetam-related AEs were reported in 24.4%. Neuropsychological AEs associated with the previous use of
levetiracetam improved in 76% of patients. Treatment was discontinued in 19.5% patients. Patients' reported seizure frequency improved, worsened and remained stable in 26.8%, 12.2%, and 61.0% of the cases, respectively. An overnight switching to
brivaracetam is safe and well tolerated. This treatment can improve
levetiracetam-related neuropsychiatric AEs.