Scientific Resources

Topic-organised database of landmark studies, guidelines, and clinical references.

Evidence review status

This directory prioritises landmark trials, clinical guidelines, public regulators, and patient organisations. Each card links directly to its source; material changes are reviewed before publication.

Last review: August 2026

Landmark Clinical Trials

The SANAD II study of the effectiveness and cost-effectiveness of valproate, levetiracetam or lamotrigine for newly diagnosed focal epilepsy

Marson A et al. — The Lancet, 2021

Lamotrigine superior to LEV for focal epilepsy (HR 1.32, p=0.018). LEV failed non-inferiority.

Randomized Trial of Three Anticonvulsant Medications for Status Epilepticus (ESETT)

Kapur J et al. — NEJM, 2019

LEV = valproate = fosphenytoin in status epilepticus. No superiority for LEV.

First Drug Choice & Refractoriness

Early Identification of Refractory Epilepsy

Kwan P, Brodie MJ. — NEJM, 2000

47% seizure-free with first drug; 11% after first fails; 4% after two failures.

False Pharmacoresistance — A True Problem

Bašić S et al. — PMC, 2021

~29% of apparent drug-resistant epilepsy may represent false pharmacoresistance from inappropriate drug choice.

Neuropsychiatric Effects

Prediction Tools for Psychiatric Adverse Effects After Levetiracetam

Josephson CB et al. — JAMA Neurology, 2019

14.1% of patients experienced psychiatric symptoms. Depression and behavioural issues most common.

Mechanisms Underlying Aggressive Behavior Induced by Levetiracetam

Hansen CC et al. — PMC, 2018

SV2A inhibition disrupts both excitatory and inhibitory neurotransmission, contributing to emotional dysregulation.

Beyond Seizure Control: Levetiracetam Neuropsychiatric Adverse Effects

Durairaj T et al. — PMC, 2025

16% behavioural side effects; 13.3% depression in real-world cohort.

Levetiracetam, perampanel, and the issue of aggression

von Wrede R et al. — Epilepsy & Behavior, 2021

10–20% of patients experience heightened irritability or aggression on levetiracetam.

Pharmacology & Mechanism

Levetiracetam Mechanisms of Action

Encyclopedia.pub — 2022

Comprehensive review of SV2A binding, vesicular priming inhibition, and downstream effects.

Clinical Guidelines

NICE BNF: Epilepsy Treatment Summaries

NICE/BNF — NICE, updated

UK national guidelines for AED selection by seizure type.

FDA Drug Safety Communication: DRESS with Levetiracetam

US FDA — FDA.gov, 2023

Rare but serious DRESS reaction associated with levetiracetam. Requires immediate clinical attention.

Patient Resources

Levetiracetam — Epilepsy Foundation

Epilepsy Foundation — epilepsy.com

Patient-facing overview of levetiracetam including dosing, side effects, and precautions.

Related project

The OCEAN Project · TopEpilepsy

Discover a project supporting epilepsy awareness and care in Fiji, with a vision to extend this work across the Pacific.

Visit TopEpilepsy.org ↗