My One-Year Review of Briviact for Epilepsy

I feel confident in talking about my newest medication. I have now been on it for 366 days. (I want to make sure that my review came after a whole year of use.) I am still on Lamotrigine, however, Briviact is the other medication I want to talk about.

Adding a "helper" medication

During the previous year, my neurologist and I were trying out different medications to help my Lamotrigine. Although I am not having seizures, my body is metabolizing my Lamotrigine quickly. (It's nice to know I have such an effective liver!) This means I need a "helper" medication.

My previous tries at "helper" medications included Keppra (see my previous article). I was not a pleasant person on Keppra. So I was then put on Zonegram. While on this medication for a little over a month, I developed 5 large kidney stones. My current career goal is to become a Pathology Assistant. That means I did find kidney stones to be beautiful. The insane amount of pain I felt did, however, dampen my enthusiasm.

After these 2 medication tries we moved on to Briviact.

Learning about Briviact for epilepsy

Fun things I've learned about Briviact as I've talked to my neurologist and read through the medication guides:^1,2

• It is an FDA-approved prescription medication used to treat partial-onset seizures in patients 1 month of age and older.
• Briviact and Keppra are both SV2A binders. SV2A stands for synaptic vesicle protein 2A. (You can read more about them here.)
• There is an injection option for the medication.
• Most common side effects include sleepiness, dizziness, feeling tired, and nausea and vomiting.

My neurologist also told me that there are no known interactions of Briviact with hormonal birth control, but there is not enough information about it and pregnancy. (He told me that Lamictal and Keppra are the safest drugs during pregnancy.) My doctor also explained to me that Briviact is broken down in the liver and is a controlled medication.

Briviact cost and insurance coverage

I immediately learned that it is a very expensive medication for my insurance to pay – $1,200 for 60 pills (one month) is insane. I have insurance so it's $40 per month. Costco typically has a less expensive option as well. For the first couple of times I was prescribed Briviact, I had to make sure my insurance understood that my neurologist wants me on Briviact. Now, I don't have any problems with insurance.

My side effects on Briviact

My experience with Briviact has been pleasant. As far as side effects, I do have some. I can get pretty tired, but I like naps. It's the best reason to take a nap while my baby is napping. Every so often I do get nauseous, but it's not debilitating. Between the 2 medications, I feel great.

Is Briviact safe during pregnancy?

Here is my only current concern. I want to get pregnant again. There isn't a lot of data on Briviact and pregnancy. Based on animal data, Briviact may cause harm to an unborn baby.²

Currently, my husband and I are deciding if I should go off Briviact and simply stay on Lamotrigine. I was on Lamotrigine during my previous pregnancy and my daughter had no side effects. As my neurologist has explained to me, Lamotrigine and Keppra are the 2 safest medication for pregnancy. I suppose this huge decision is for another article...

Always remember, you are not alone.