THERAPEUTIC COMPARISON OF BRIVARACETAM AND LEVETIRACETAM IN OLDER ADULTS WITH EPILEPSY: QUALITY OF LIFE AND TOLERABILITY OUTCOMES

Vincy Ramya C.*, Dr. M. K. Sundar Sri

Epilepsy in older patients presents specific clinical challenges due to age-related changes in the body, the use of multiple medications, and increased sensitivity to side effects. Among the second-generation antiepileptic drugs (AEDs), Brivaracetam and Levetiracetam are commonly prescribed for focal seizures. Both drugs target synaptic vesicle protein 2A (SV2A) to provide their antiepileptic effects, but they differ in how they are processed by the body, their effects on mental health, and their tolerability. This review compares Brivaracetam and Levetiracetam for elderly epilepsy patients, focusing on their effectiveness, impact on quality of life, safety, and tolerability. Levetiracetam is effective but often linked to behavioral side effects, such as irritability and depression, which can reduce quality of life and adherence to treatment. Brivaracetam has a higher binding affinity for SV2A and better tolerability, making it a potentially better choice, especially for patients who cannot tolerate Levetiracetam. The review highlights the need for personalized treatment approaches to enhance seizure control and reduce side effects in older patients.