Yes, Briviact (brivaracetam) is a controlled substance. The DEA placed it in Schedule V of the Controlled Substances Act, effective May 12, 2016. Schedule V is the lowest level of control, meaning the drug has some potential for abuse but significantly less than medications in higher schedules like Schedule IV (which includes drugs like benzodiazepines).
What Schedule V Means in Practice
The federal scheduling system runs from Schedule I (highest abuse potential, no accepted medical use) down to Schedule V (lowest abuse potential among controlled substances). Briviact sits at the bottom of that ladder. By definition, Schedule V drugs have a currently accepted medical use, a low potential for abuse compared to Schedule IV substances, and may lead to limited physical or psychological dependence.
For you as a patient, Schedule V status means your prescription may come with a few extra steps compared to an uncontrolled medication. Pharmacies track dispensing more carefully, and some states have additional requirements around refills or transfers. However, Schedule V prescriptions are far less restrictive than those for Schedule II or III drugs. You won’t face the same tight refill limits that apply to opioids or stimulants.
Why Briviact Is Controlled When Keppra Is Not
This is one of the more common questions about Briviact, since it’s chemically related to levetiracetam (Keppra), a widely used seizure medication that is not a controlled substance at all. Both drugs work by binding to the same target in the brain, a protein called SV2A that sits on the surface of synaptic vesicles and helps regulate how nerve signals are transmitted. But brivaracetam binds to that protein with roughly 20 times higher affinity than levetiracetam, and it’s about 10 times more potent in animal models of epilepsy.
That greater potency appears to translate into a measurable difference in how the drug feels at high doses. In a human abuse potential study, researchers gave healthy recreational drug users single doses of brivaracetam at various levels and compared their responses to a placebo and to alprazolam (a benzodiazepine). At the standard therapeutic dose of 50 mg, brivaracetam produced significantly less “drug liking” than alprazolam. But at extremely high supratherapeutic doses (1,000 mg, or 10 times the typical starting dose), brivaracetam produced drug-liking scores comparable to or even higher than alprazolam. That signal at very high doses is likely what pushed regulators toward scheduling, even though the risk at normal doses appears low.
What Briviact Treats
Briviact is FDA-approved for the treatment of partial onset seizures (also called focal seizures) in patients as young as one month old. For adults and teenagers 16 and older, the typical starting dose is 50 mg taken twice daily, with a maximum of 100 mg twice daily. Dosing for younger children is based on body weight.
The drug can be used on its own or added to other seizure medications. It’s available as tablets, an oral solution, and an injectable form for hospital use.
Dependence and Withdrawal Risk
Despite its controlled status, clinical trial data show no evidence of physical dependence with Briviact. In pooled analyses from placebo-controlled studies, patients who stopped taking the drug did not experience a classic withdrawal syndrome the way someone might with a benzodiazepine or opioid.
That said, you should not stop Briviact abruptly. This isn’t because of drug dependence in the traditional sense. It’s because stopping any seizure medication suddenly can cause a rebound increase in seizure frequency or even status epilepticus, a dangerous condition where seizures don’t stop on their own. The standard recommendation is to taper off gradually. If a serious side effect requires faster discontinuation, that decision is made on a case-by-case basis.
Side Effects to Be Aware Of
The most commonly reported side effects of Briviact include drowsiness, dizziness, and fatigue, which are typical for seizure medications. Psychiatric and behavioral side effects deserve particular attention: in clinical trials, about 11% of patients on Briviact experienced drug-related psychiatric or behavioral effects compared to roughly 5% on placebo. The most frequent of these were irritability, insomnia, depression, and anxiety.
If you’re switching to Briviact from levetiracetam partly because of mood-related side effects (a common reason for the switch), it’s worth knowing that Briviact can still cause similar issues in some people, though many patients do report improvement. Tracking your mood during the first few weeks of treatment gives you useful information to bring back to your prescriber.
Filling and Refilling Your Prescription
Because Briviact is Schedule V, your pharmacy will handle it as a controlled substance. In most states this means your prescription can be refilled up to five times within six months, similar to Schedule III and IV drugs. Some states impose tighter rules on all controlled substances regardless of schedule, so your pharmacy’s policies may vary depending on where you live. If you’re traveling, carrying your medication in its original labeled container is always a good practice with any controlled substance.