Evidence map›Paper›PMID 41824075›Full record

SynthesisJournal of neurology2026

Reassessing the adverse event profiles of levetiracetam and brivaracetam: a systematic review and meta-analysis.

Emma Fröling, Mariel Morales Sahm, Marcel Schmude, Charlotte P Assies, Michael Wittenberg, Felix Rosenow, Felix Bermpohl, Thomas G Riemer

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Emma FrölingDepartment of Psychiatry and Psychotherapy, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10115, Berlin, Germany.ORCID https://orcid.org/0009-0000-6501-3361
Mariel Morales SahmDepartment of Psychiatry and Psychotherapy, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10115, Berlin, Germany.ORCID https://orcid.org/0009-0005-8880-0380
Marcel SchmudeInstitute of Clinical Pharmacology and Toxicology, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10117, Berlin, Germany.ORCID https://orcid.org/0000-0002-7519-1724
Charlotte P AssiesInstitute of Psychology, Heidelberg University, 69117, Heidelberg, Germany.
Michael WittenbergDepartment Marburg, Faculty of Medicine, Coordinating Center of Clinical Trials, Marburg University, 35043, Marburg, Germany.ORCID https://orcid.org/0000-0003-4526-1856
Felix RosenowDepartment of Neurology, Epilepsy Center Frankfurt Rhine-Main, Universitätsmedizin Frankfurt, Goethe-Universität Frankfurt, 60590, Frankfurt, Germany.ORCID https://orcid.org/0000-0002-3989-7471
Felix BermpohlDepartment of Psychiatry and Psychotherapy, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10115, Berlin, Germany.ORCID https://orcid.org/0000-0002-3260-6328
Thomas G RiemerDepartment of Psychiatry and Psychotherapy, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 10115, Berlin, Germany. thomas.riemer@charite.de.ORCID https://orcid.org/0000-0002-8068-3192

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo synthesize adverse event (AE) data from randomized controlled trials (RCTs) of levetiracetam (LEV) and brivaracetam (BRV), compare their safety profiles, and identify moderators of AE risk.

methodsWe conducted a systematic review and meta-analysis of RCTs of LEV or BRV, searching PubMed, Web of Science, and ClinicalTrials.gov to August 2025. AE frequencies were summarized qualitatively, and random-effects meta-analyses compared LEV and BRV with placebo. Additional analyses compared LEV and BRV and assessed moderators. PROSPERO: CRD42023491050, CRD420251003207.

resultsNinety-six RCTs including 7145 patients exposed to LEV and 2549 to BRV were analyzed. Qualitative synthesis identified headache, somnolence, dizziness, and fatigue as the most common AEs, with higher frequencies of some psychiatric AEs (e.g., irritability, aggression) reported for LEV. Meta-analyses showed increased somnolence with both LEV (OR 1.80, 95% CI [1.41-2.30]) and BRV (OR 1.86, 95% CI [1.33-2.61]). LEV was additionally associated with irritability (OR 2.55, 95% CI [1.41-4.63]) and asthenia (OR 1.71, 95% CI [1.15-2.54]), whereas BRV was associated with dizziness (OR 1.75, 95% CI [1.24-2.46]) and fatigue (OR 2.14, 95% CI [1.43-3.20]). Few moderators of AE risk were identified, and no significant differences emerged between LEV and BRV in indirect comparisons.

conclusionLEV and BRV show favorable safety profiles that appear comparable based on meta-analytic findings, despite higher rates of some psychiatric AEs with LEV on a descriptive level. Both remain safe treatment options, though larger head-to-head trials are needed to provide definitive comparative evidence.

Indexed as

AnticonvulsantsEpilepsyLevetiracetamPyrrolidinonesDizzinessHumansRandomized Controlled Trials as TopicAnticonvulsantsbrivaracetamLevetiracetamPyrrolidinonesAnticonvulsantsAntiseizure medicationEpilepsySafety profile

Identifiers

PMID41824075
PMCPMC13437759

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.