Keppra vs. Briviact for Epilepsy: Important Differences and Potential Risks.

Key takeaways

Levetiracetam (Keppra) and brivaracetam (Briviact) are both antiepileptic medications used to treat seizures, but they have some differences. Levetiracetam is available in both generic and brand forms, while brivaracetam is only available as the brand Briviact. Levetiracetam can be taken as an immediate-release tablet, extended-release tablet, or liquid, and is usually taken once or twice a day. Brivaracetam, on the other hand, is typically taken twice daily and comes as a tablet, oral solution, and injection. Levetiracetam is not a controlled substance, whereas brivaracetam is a Schedule V controlled substance, meaning it has some potential for abuse and dependence. Common side effects of levetiracetam include sleepiness, weakness, and headaches, while brivaracetam often causes drowsiness and dizziness.

Levetiracetam

(Keppra)

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Briviact

(brivaracetam)

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Summary for Keppra

Prescription only

Immediate-release levetiracetam is a seizure medication for adults and children. It's known as the brand names Keppra and Roweepra, and it also has a generic version. This medication comes as a tablet and liquid that's taken twice each day. The dosage depends on your age, weight, and the type of seizure you have. Levetiracetam (Keppra) doesn't have any known interactions with food or medications. Common side effects include weakness, sleepiness, and headache.

Indications for Keppra

Focal aware (partial-onset) seizures in people ages 1 month and older
Add-on treatment for myoclonic seizures from juvenile myoclonic epilepsy in people ages 12 years and older
Add-on treatment for generalized tonic-clonic seizures in people ages 6 years and older

Pros and Cons for Keppra

Pros

Available as tablets and a liquid (liquid recommended for children weighing 44 lbs or less)
Taken by mouth with or without food
Usually tolerated well

Cons

Need to take twice per day
Might cause changes in behavior or mood
Might not be the best option if you have a history of mental health problems (e.g., depression, schizophrenia, bipolar disorder)

Common Side Effects for Keppra

Side effects were reported by people with focal aware seizures taking levetiracetam (Keppra) with other seizure medications. Side effects might differ for other seizure types.
Adults:

Weakness (15%)
Sleepiness (15%)
Headache (14%)
Infection (13%)
Dizziness (9%)

Children:

Headache (19%)
Common cold symptoms (15%)
Vomiting (15%)
Sleepiness (13%)
Tiredness (11%)
Being aggressive (10%)
Cough (9%)
Stuffy nose (9%)
Upper stomach pain (9%)
Lower appetite (8%)

Warnings for Keppra

Abnormal mood, thoughts, or behavior
Suicidal thoughts or behavior
Difficulty with speech, movement, and concentration
Serious allergic reactions and skin reactions
Withdrawal seizures
Low blood cell counts
Higher blood pressure in young children
Seizure control during pregnancy

Summary for Briviact

Prescription only

Briviact (brivaracetam) is used to treat partial-onset seizures (also known as focal onset aware seizures). It's approved for adults and children ages 1 month and older. This antiepileptic medication works by helping to calm brain activity. Briviact (brivaracetam) comes as a tablet and oral solution that you take by mouth twice a day. It also comes as an injection given into the vein (IV) by a healthcare professional when in the hospital. Side effects include drowsiness and dizziness. As of mid 2025, there's no generic version of this medication available.

Indications for Briviact

Partial-onset seizures

Pros and Cons for Briviact

Pros

Can help control seizures if other medications aren't working well enough
Usually don't need to check medication levels through blood draws
Available as a tablet and liquid (for people who can't swallow pills)

Cons

Need to take twice a day
Might not be the best option if you have mood problems (e.g., depression, schizophrenia, bipolar disorder)
Can make seizures come back if you stop taking it all of a sudden