• antiepileptic drugs (AEDs) are the main treatment

method for epilepsy patients, and it was reported

that approximately two-thirds of epileptic seizures
were controlled by AEDs
• Some classic AEDs i.e. CBZ and VPA exert side
effects that may affect tolerance and compliance of
patients
A total of 14,803 records were obtained. We included 30 SRs/meta-analyses, 34 RCTs, 18
observational studies, 58 case reports and 2 economic studies after the screening process
LEV was as effective as
carbamazepine (CBZ; treatment for 6 months: 58.9% vs 64.8%,
OR=0.76, 95% CI: 0.50–1.16; 12 months: 54.9% vs 55.5%,
OR=1.24, 95% CI: 0.79–1.93)
oxcarbazepine (57.7% vs 59.8%, OR=1.34, 95% CI: 0.34–5.23)
phenobarbital (50.0% vs 50.9%, OR=1.20, 95% CI: 0.51–2.82)
lamotrigine (LTG; 61.5% vs 57.7%, OR=1.22, 95% CI: 0.90–
1.66)
• no difference when LEV was compared with
placebo (OR=1.10, 95% CI: 0.59–2.05), CBZ
(OR=0.83, 95% CI: 0.35–1.95) and LTG (OR=1.40,
95% CI: 0.74–2.62) in the rates of serious AEs.
AE on LEV vs placebo
• Nasopharyngitis 1.49 (0.99-2.24)
• Dizziness 0.77 (0.48 – 1.22)
• Somnolence 1.49 (0.90-2.44)
• Headache 0.65 (0.36-1.17)
• Fatigue 0.98 (0.48-1.98)
• Irritability 11.55 (2.12-62.90)
AE on LEV vs CBZ
• Nasopharyngitis 1.06 (0.78-1.45)
• Dizziness 1.02 (0.68 – 1.53)
• Somnolence 1.30 (0.86-1.97)
• Headache 0.91 (0.74-1.12)
• Fatigue 0.90 (0.55-1.49)
• Diarrhea 0.88 (0.59-1.31)
• Rash 0.42 (0.25-0.73)
• Increased liver parameters 0.19 (0.08-0.46)
• Nausea 0.69 (0.49-0.97)
• Weight gain 0.73 (0.39-1.38)
• Constipation 1.15 (0.67-1.98)
• Vertigo 0.92 (0.48-1.77)
• Depression 2.18 (1.24-3.82)
• Leukopenia 0.13 (0.02-0.72)
• LEV was not associated with a higher risk compared to
control (RR=0.32, 95% CI: 0.10–1.07 and OR=0.72, 95% CI:
0.43–1.16, respectively)
• LEV had a low malformation rate for pregnant women
(OR=0.63, 95% CI: 0.16–2.55 for monotherapy and
OR=1.08, 95% CI: 0.27– 4.43 for polytherapy), data in the
EURAP registry indicated low intrauterine death rates
(8.6%, 95% CI: 5.8%–12.3%).
• did not increase the risk for delayed development of
children (cognitive development delay: OR=3.42, 95%
Credible Interval: 0.65–16.40; psychomotor development
delay: OR=0.27, 95% Credible Interval: 0.00–4.65).