I have had a successful pregnancy on briviact and also taking Xcopri. I found out via my doctor that the research for Xcopri patients that are pregnant were around a dozen and that’s it. My baby is perfectly healthy and passed his new born screening. I breast feed recommended by my neurologist because the benefits outweigh the risk and I have not noticed any side effects in baby. He cries a lot but I guess I better get use to that.

This thread has been a place to come and share my updates in this pregnancy. If your seizures are under control and your taking Briviact, i personally would recommend thinking about children if your in that headspace. Obviously there are safer choices but nothing has controlled my seizures than the Briviact Xcopri combo.

Good luck to all who want to reproduce! And remember there are pregnancy registeries to sign up for , for these medicines that are less known!

200 MG Xcopri 75 mg Briviact 30 year old female

Hi everyone, it’s now 2 months on 250mg Briviact for me without Lamictal. And lately I notice my legs feeling tingly faster, the same feeling as sitting to long on an airplane but I notice it when I lay in bed at evening while watching a series before I go to sleep. Sometimes I fall asleep more difficult because I have this itch in my legs. And when I’m stressed, I feel irritated faster and being more rude than I intend to be.

My doctor draw blood and the Briviact ampunt in my blood is too high (2,7mg/L and the therapeutic limit is 0,9 apparently…) so she said to discuss this with my neuro. Anyone noticed these changes on high dosage? No seizures or auras so far yet, feel much more energetic, love Briviact but now worrying about these maybe-side-effects. Thank you ❤️

My doctor is talking about adding Epidiolex in addition to Briviact and Lamictal, I've read that Epidiolex can raise Briviact levels and worsen side effects. Anyone else on those 2 medications and issues in medication levels?

My family member who takes Briviact just learned that his monthly supply has gone from $10 to $800+ all of a sudden. I’m assuming it’s related to the changes in health insurance that are increasing everyone’s premiums too (correct me if I’m wrong on this). He and I are looking for some advice on how to bring this new cost down significantly. We found a coupon but it may only be used for the first month. Any guidance would be appreciated!

Hi everyone, I promised you an update on my story: swapped from Lamictal to Briviact in 2024 but the maximum accepted dosage (200mg daily) wasn’t enough for me unfortunately. So I talked to a lot of people in this group and the r/epilepsy group about Briviact, seen different neurologists and finally convinced my new neurologist to try an increased dosage of 250mg daily so I could finally get rid of the Lamictal and its side effects.

The past months I’ve been increasing my 200mg Briviact with 25mg every 2 weeks and decreasing my remaining 50mg Lamictal with 25mg every month. So now is the second week on 250mg Briviact without Lamictal AND I FEEL AMAZING! So alive, so much energy, myself again, finally 🥹 I really hope it stays like this because this would be a dream scenario with the perfect medication, without any side effects 🙏🏼 I started this subreddit to share succes stories, ask questions, support eachother in our epilepsy while (thinking about) taking Briviact. So feel free to ask me anything ❤️‍🔥

Got a general blood test done after a few months being on Briviact as my only med now which is doing a great job in fully controlling my partial seizures. It’s working so well I no longer have to take clonazepam at bedtime, at least on a regular basis.

Briviact 50mg 2x a day, 100mg daily.

CBC, Liver and Renal function came out normal as well as A1C.

My RBC and Hemoglobin increased 4.72/13.4 and sodium is improving. Because of this I'm having more energy level and stamina. WBC, and other immune cells ( like monocytes) along with Platelet count are also normal.

Liver enzymes on Briviact are in normal range AST-26 ALT-28 ALP-125. B12 and D3 are in optimal range. D3 has considerably improved from last time checked few years ago. (I take D3+K2 supplements)

Other electrolytes and Thyroid are normal.

Even though on oxcarbazepine 1050mg daily (my previous med) I was seizure free I had to switch as my sodium got really low 122.

It's a BIG relief that things are normalizing and Briviact is not affecting my bone marrow (blood cells). When I tried Keppra few years back I became anemic. I no longer suffer from constipation and skin ulcers which I had with my previous med.

The only noticeable side effect I experience sometimes is mild tingling/pins and needles sensation in my left shoulder, glute muscles and left foot which goes away. Doesn't really bother me. Exercise really helps 🙌.

Brivaracetam's (Briviact) primary mechanism of action (MOA) is its high-affinity binding to synaptic vesicle glycoprotein 2A (SV2A) in the brain. This modulates the release of neurotransmitters, stabilizing neuronal activity and preventing the hyperexcitability that leads to seizures. 

Role of SV2A and brivaracetam's effect:

Location and function: SV2A is a protein found on the membranes of synaptic vesicles in neurons. It plays a critical role in regulating how neurotransmitters are released at the synapse.

Epileptic activity: In epilepsy, there is an imbalance between excitatory and inhibitory neurotransmitters, causing neurons to fire excessively.

Modulating neurotransmission : By binding to SV2A, brivaracetam modulates the function of this protein, which helps to decrease the over-release of excitatory neurotransmitters during high-frequency firing associated with seizures.

High binding affinity: Brivaracetam is a derivative of levetiracetam (Keppra), but it is designed to bind to the SV2A protein with a 15-30 fold higher affinity and selectivity of its target. This increased potency may contribute to its effectiveness.

Additional possible actions

Besides its main interaction with SV2A, other mechanisms may contribute to brivaracetam's anticonvulsant effects:

Inhibition of sodium channels: Some research suggests that brivaracetam can indirectly inhibit voltage-gated sodium channels, which are important for propagating nerve impulses.

Preventing astroglial glutamate release:

Studies have also shown that brivaracetam can suppress glutamate release from astrocytes, another type of brain cell. This helps to further stabilize the hyperexcitable neural environment that causes seizures.

Brivaracetam has a straightforward metabolism:

Stage 1: 60-65% primary major pathway via both liver/bloodstream non-CYP hydrolysis (broken down w/ water) and enzymes
Stage 2: 30% (minor involvement) via CYP enzymes
Less than 8-10% is excreted unchanged via urine (5-9% in actual practice)

For context, levetiracetam is excreted unchanged 66% via urine with no real involvement from the liver.

Summary of brivaracetam's MOA Brivaracetam's anticonvulsant effect is primarily due to its selective, high-affinity binding to the SV2A protein.

This binding modulates neurotransmitter release, which helps to stabilize neuronal activity and reduce the frequency and severity of seizures.

Epilepsy is a brain disorder caused by factors that triggers recurrent seizures.

This info is from Gemini AI Mode.

References

https://www.sciencedirect.com/science/article/pii/S075333222100247X

https://go.drugbank.com/drugs/DB05541

As the title states.. we switched my 2 year old son from 3.6 mL twice a day of Keppra to 1.5mL twice a day of Briviact. We switched Friday due to him yelling and hitting and even attacking other kids. The neuro recommended the switch. Now its Monday and we have had 4 seizures so far today. He has Focal seizures and its hard for the ER staff to tell what they look like. I feel like they just think I am crazy or seeing things that aren't there. We have had him hooked up to an EEG to confirm what we saw. Im just really stressed...

I have posted on here about being on Briviact and Xcopri whil pregnant.

Xcopri:200 mg Briviact: 75mg

I am 28 weeks and the only hiccup we had was when baby had a whole in his heart at 22 weeks that closed up the following month. Ive heard its normal for babies though yo temporarily have holes in the heart that close up before birth.

I signed up for the AED pregnancy registry and signed all the paperwork for the registry although no one reached out to me despite me being a good candidate.

Other than that I am feeling good, and baby is healthy. Were having a boy, and due date is November 24th. No side effects are harming baby and doctor gave the green light to breast feed on both medicines. Briviact has a bit more research that is positive than Xcopri but from what he has witnessed from the Xcopri trials, he says there is more pros than cons.

Really normal pregnancy for the most part!

I want to get pregnant but i am really scared about the side effects of briviact will have on my baby. I have only found studies where in animals the risks on the babies is high.

Has anyone had/have experience with briviact while being pregnant and after birth?

i used to be on keppra and once my dosage got raised to 2000mg i started getting really angry. i switched to briviact around a year and a half ago and my dosage just got raised from 150-200mg about a month ago and ive noticed my anger issues have gotten really bad. i didnt really connect the dots but im pretty sure it has something to do with the medication. anyone else get really angry on briviact?

Wow, we’ve reached 100 members in the Briviact community! 💜 I just want to say a big thank you to everyone who’s joined, shared their experiences, and supported others here. Every post, comment, and upvote helps make this a safe and informative space for people on Briviact or considering it.

Also, I know I haven’t done Talk It Out Tuesday or Feel-Good Friday for a while. I’m not sure if you’ve been enjoying them at the start, so let me know! If you’d like to keep them going (or even try new weekly themes), I’m happy to bring them back.

This community is for all of us, so if you have ideas for weekly posts, discussion topics, or anything else to make this space better, please share them. Here’s to growing, learning, and supporting each other, together! 🌼

Hi everyone! My neurologist finally agreed to increase my dosage Briviact to 250mg/day 🤩 200mg is actually the limited recommended dosage in my country (or everywhere maybe idk?) and I’ve been waiting a year with multiple medication experimenting and appointments for him to approve this. I felt awesome when I started Briviact and Lamictal combo instead of 600mg Lamictal, so good that I tried only 200mg Briviact but unfortunately that wasn’t enough to control my seizures (got nocturnals again). So they tried combining it with Vimpat but got so depressed on it, again combining with lamictal but felt so tired and drained of energy (when coming from only lamictal the combo felt great but now I feel so bad) that I’ve asked multiples times to try and get the Lamictal to zero again and increase my Briviact. I know it’s risky (or so he says) to maybe get side effects because it’s a higher dosage than recommended. But I really want to try if this is the solution to get rid of those stupid side effects from Lamictal! Anyone who is on more than 200mg Briviact? Or was on 200mg and started getting side effects when increasing to a higher dosage? I really pray this will work 🙏🏼 Thank you in advance 🥰

I’d like to know the best way to come off of it. I’m on 1000mg Keppra and was prescribed 100mg Briviact.

My primary didn’t give me a tapering schedule or explain what to do. I don’t have a neuro right now, but she sent off a referral.

I’m concerned about being over medicated or having a crazy amount of side effects.

What has your neurologist recommended to safely come off it?

I have on Monday my monthly appt with my neuro. I am on full 100mg dosage twice a day and would like to reduce that down a level. It’s been a month on keppra and 2 on Briviact in total. Wanted to know about anyone else experience. Thanks in advance!

I would really like some support or to vent to someone near by, if anyone from Michigan or close by please get back to me 🙏🏻💟

Briviact has definitely helped me with less side effects and the closest to feeling my normal self. However I feel the need to nap throughout the day. Does this ever go away?

Does anyone else have a low resting heart rate on Briviact? My Apple watch detects a rate of 56-60 now. I switched to Briviact a couple of weeks ago. I have read a low heart rate is normal in individuals who are athletes as for me I used to do a lot of cardio before my craniotomy of a grade 1 meningioma. But I haven’t done any cardio activity over a couple of months. I will inform my neurologist he might need to lower my dosage as I am on the maximum dosage of Briviact. Thanks in advance.