Brivaracetam (BRV) is approved as an adjunctive therapy in the treatment of focal seizures, either with or without secondary generalisation, for patients from the age of four [1]. BRV is commercially available in the Netherlands since 2016. LEV and BRV share a similar mechanism of action in seizure reduction. Both target the transmembrane synaptic vesicle protein 2A (SV2A) [2]. However, BRV was found to have a 15- to 30-fold higher affinity and a higher selectivity for the SV2A receptor than LEV [3].
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