Brivaracetam to Treat Partial Onset Seizures in Adults

Abstract

Purpose of Review Seizures are a hyperexcitable, and hypersynchronous imbalance between excitatory and inhibitory factors (E/I imbalance) in neurotransmission, and epilepsy is the recurrent manifestation of seizures within a reasonable time frame and without being attributable to a reversible cause. Brivaracetam is a derivative of the antiepileptic agent, levetiracetam, that is used as adjuvant therapy for focal onset seizures. It was approved by the FDA in 2016 and has shown promising results with minimal adverse effect reactions in clinical trials. Recent Findings Brivaracetam has been used in multiple clinical trials at various dosages in adults that have partial-onset seizures refractory to conventional treatment. A meta-analysis in 2016 showed that brivaracetam as adjunctive therapy was statically significant in its reduction of adults with drug-refractory seizure frequency.1 The most commonly reported adverse effects that patients who were taking brivaracetam experienced were somnolence, headache, and dizziness. Further studies are necessary to conclude long term efficacy and safety profile of brivaracetam. Conclusion The treatment of epilepsy with pharmacologic agents is a difficult task due to balancing the efficacy of the drug with the side effect profile that will allow for the best quality of life for the patient. There are approximately 30 antiepileptic agents for clinicians to choose from. Brivaracetam is a novel antiepileptic agent that was approved for use by the FDA in 2016 and is showing promising results as monotherapy and adjunctive therapy in individuals with drug-refractory focal seizures while minimizing adverse drug reactions.

Systematic review and rationale of using psychedelics in the treatment of cannabis use disorder

“…MDMA, a stimulant with mixed pharmacological effect which include the increase of oxytocin, has shown tremendous promise as a novel treatment for posttraumatic stress disorder (PTSD), and therefore has undergone increasing study and scrutiny ( 41 ). Given the higher prevalence of cannabis use and CUD in those with PTSD compared to the general population ( 42 ), it should be anticipated that MDMA could be therapeutically administered in persons with co-morbid disorders.…”

MDMA-assisted psychotherapy in the treatment of PTSD in adults – literature review

“…Jedną z metod leczenia PTSD jest psychoterapia skoncentrowana na traumie, w której stosuje się metodę ekspozycji przedłużonej. Polega ona na przywoływaniu traumatycznego zdarzenia, opisaniu go i przetworzeniu w bezpiecznej atmosferze (Latimer et al, 2021). Amerykańskie Towarzystwo Psychiatryczne zaleca połączenie psychoterapii z farmakoterapią.…”

“…One of the methods to treat PTSD is trauma-focused psychotherapy using the prolonged exposure method. It involves recalling a traumatic event, describing it and processing it in a safe atmosphere (Latimer et al, 2021). The American Psychiatric Association recommends a combination of psychotherapy and pharmacotherapy.…”

“…Nevertheless, based on a meta-analysis, Hoskins et al demonstrated that some SSRIs and SNRIs (fluoxetine, paroxetine and venlafaxine) have only a small positive therapeutic effect compared to placebo, while no evidence was found for a positive effect of olanzapine, brofaromine, sertraline or topiramate (Hoskins et al, 2015). A number of studies indicate a positive effect of using 3,4-methylenedioxymethamphetamine (MDMA) combined with psychotherapy in the treatment of PTSD (Latimer et al, 2021;Mitchell et al, 2021).…”

Psychedelics as a treatment for patients with post-traumatic stress disorder (PTSD)

“…As outlined in the DSM-5, post-traumatic stress disorder (PTSD) is a mental health condition resulting from experiencing a traumatic event, specifically involving actual or threatened death, severe injury, or sexual violence [2], around 1-8% of the population to varying degrees, is affected [3]. In an era of several political conflicts around the world, mass migration, and increased violence, it seems essential to research and broaden the spectrum of tools, apart from those in common use, that could help the patients under diverse conditions effectively deal with PTSD, whose symptoms encompass dissociative reactions, flashbacks, ongoing avoidance of trauma-related triggers or social contacts, aggressiveness, feelings of guilt, and more [4].…”