Levetiracetam (Epilepsy) updated on 04-22-2025

ADHD (Attention deficit hyperactivity disorder): Diagnosis

R analysis
id Study   Lib. in paper Exposition period    Study type 
 Control type 
 
Tags OR 95%CI x1/n1 x0/n0 no cases no exposed ROB Ref.
S19458
R82949		 Straub (Controls exposed to LTG) (Levetiracetam) (Epilepsy), 2026 Attention deficit hyperactivity disorder (ADHD) - ICD-10 codes: F90.x - Mean follow up (full cohort): 3.4 years during pregnancy (anytime or not specified) retrospective cohort (claims database) exposed to other treatment, sick excluded Adjustment: No 0.56 [0.41;0.76] C
excluded (control group) 		69/3,929   102/3,273 171 3,929
ref
S19468
R83035		 Straub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Attention deficit hyperactivity disorder (ADHD) - ICD-10 codes: F90.x - Mean follow up (full cohort): 3.4 years during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes 0.89 [0.68;1.17] 69/3,929   366/8,887 435 3,929
ref
S17431
R73227		 Madley-Dowd_SE (Levetiracetam) (Controls exposed to LTG), 2024 Attention Deficit Hyperactivity Disorder - ICD-8/9/10 codes and/or ADHD medication prescription - Mean 5-20 years old (according groups) during pregnancy (anytime or not specified) population based cohort retrospective exposed to other treatment, sick excluded Adjustment: No Partial overlapping 0.54 [0.31;0.95] C
excluded (control group) 		14/556   109/2,383 123 556
ref
S17432
R73233		 Madley-Dowd_SE (Levetiracetam) (Controls unexposed, sick), 2024 Attention Deficit Hyperactivity Disorder - ICD-8/9/10 codes and/or ADHD medication prescription - Mean 5-20 years old (according groups) during pregnancy (anytime or not specified) population based cohort retrospective unexposed, sick Adjustment: Yes Partial overlapping 0.99 [0.58;1.68] 190/556   929/10,769 1,119 556
ref
S17252
R72209		 Madley-Dowd_UK (Levetiracetam) (Epilepsy), 2024 Attention Deficit Hyperactivity Disorder - ICD10 codes and/or ADHD medication prescription - Median 4.19 (2.56-6.79) years old during pregnancy (anytime or not specified) retrospective cohort (claims database) unexposed, sick Adjustment: Yes 1.23 [0.16;9.58] -/174   38/4,075 - 174
ref
S15871
R65400		 Dreier (Levetiracetam) (Epilepsy) (Controls exposed to LTG), 2023 Attention-deficit/hyperactivity disorder (ADHD) - Corresponding ICD-10 F-chapter - Up to 22 years of age during pregnancy (anytime or not specified) population based cohort propective exposed to other treatment, sick excluded Adjustment: No 0.73 [0.42;1.29] C
excluded (control group) 		14/1,061   95/5,288 109 1,061
ref
S15872
R65408		 Dreier (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023 Attention-deficit/hyperactivity disorder (ADHD) - Corresponding ICD-10 F-chapter - Up to 22 years of age during pregnancy (anytime or not specified) population based cohort propective unexposed, sick Adjustment: Yes 1.78 [1.03;3.07] 14/1,061   528/22,203 542 1,061
ref
S7511
R22514		 Huber-Mollema (Levetiracetam), 2019 Diagnosis of ADHD throughout pregnancy prospective cohort exposed to other treatment, sick Adjustment: No 0.25 [0.01;4.74] C 0/30   5/88 5 30
ref
Total 5 studies 1.07 [0.77;1.51] 2,101 5,750
x1: number of endpoints among exposed, n1: number of exposed; x0: number of endpoints among non exposed, n0: number of non exposed; C: calculated odds ratio from numbers of events and effectives

Forest plot

StudyTE95% CIn casesn exposedweightROBABCDEF Straub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026Straub, 2026 1 0.89[0.68; 1.17]4353,92947%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: unclearROB mesure: criticalROB reporting: moderate Madley-Dowd_SE (Levetiracetam) (Controls unexposed, sick), 2024Madley-Dowd_SE, 2024 2 0.99[0.58; 1.68]1,11955625%ROB confusion: moderateROB selection: lowROB classification: lowROB missing: lowROB mesure: moderateROB reporting: moderate Madley-Dowd_UK (Levetiracetam) (Epilepsy), 2024Madley-Dowd_UK, 2024 3 1.23[0.16; 9.58]-1743%ROB confusion: moderateROB selection: lowROB classification: criticalROB missing: unclearROB mesure: moderateROB reporting: moderate Dreier (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023Dreier, 2023 4 1.78[1.03; 3.07]5421,06124%ROB confusion: seriousROB selection: lowROB classification: moderateROB missing: lowROB mesure: criticalROB reporting: moderate Huber-Mollema (Levetiracetam), 2019Huber-Mollema, 2019 5 0.25[0.01; 4.74]5301%ROB confusion: criticalROB selection: lowROB classification: moderateROB missing: criticalROB mesure: moderateROB reporting: moderate Total (5 studies) I2 = 32% 1.07[0.77; 1.51]2,1015,7500.25.01.0ROB: A: confounding, B: selection, C: classification, D: missing, E: measurement, F: reportinglow,moderate,serious,critical,unclear,

1: Controls unexposed, sick) (Levetiracetam) (Epilepsy; 2: Levetiracetam) (Controls unexposed, sick; 3: Levetiracetam) (Epilepsy; 4: Levetiracetam) (Epilepsy) (Controls unexposed, sick; 5: Levetiracetam;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.07[0.77; 1.51]2,1015,75032%NAStraub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Madley-Dowd_SE (Levetiracetam) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Levetiracetam) (Epilepsy), 2024 Dreier (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023 Huber-Mollema (Levetiracetam), 2019 5 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.10[0.77; 1.56]2,0965,72040%NAStraub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Madley-Dowd_SE (Levetiracetam) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Levetiracetam) (Epilepsy), 2024 Dreier (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023 4 exposed to other treatment, sickexposed to other treatment, sick 0.25[0.01; 4.74]530 -NAHuber-Mollema (Levetiracetam), 2019 1 Tags Adjustment   - No  - No 0.25[0.01; 4.74]530 -NAHuber-Mollema (Levetiracetam), 2019 1   - Yes  - Yes 1.10[0.77; 1.56]2,0965,72040%NAStraub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Madley-Dowd_SE (Levetiracetam) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Levetiracetam) (Epilepsy), 2024 Dreier (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023 4 Partial overlappingPartial overlapping 0.99[0.58; 1.68]1,119556 -NAMadley-Dowd_SE (Levetiracetam) (Controls unexposed, sick), 2024 1 All studiesAll studies 1.07[0.77; 1.51]2,1015,75032%NAStraub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Madley-Dowd_SE (Levetiracetam) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Levetiracetam) (Epilepsy), 2024 Dreier (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023 Huber-Mollema (Levetiracetam), 2019 50.15.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.53.61.7910.000Straub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026Madley-Dowd_SE (Levetiracetam) (Controls unexposed, sick), 2024Madley-Dowd_UK (Levetiracetam) (Epilepsy), 2024Dreier (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023Huber-Mollema (Levetiracetam), 2019

Asymetry test p-value = 0.8758 (by Egger's regression)

slope=-0.0262 (0.2630); intercept=0.1789 (1.0521); t=0.1700; p=0.8758

p values plot
0.01.00.01.0

Sub-groups analysis using all included studies

excluded 15871, 17431, 19458

Sub-groupsTE95% CIn casesn exposedkI2ROB type of controls unexposed, sick controlsunexposed, sick controls 1.10[0.77; 1.56]2,1255,72040%NAStraub (Controls unexposed, sick) (Levetiracetam) (Epilepsy), 2026 Madley-Dowd_SE (Levetiracetam) (Controls unexposed, sick), 2024 Madley-Dowd_UK (Levetiracetam) (Epilepsy), 2024 Dreier (Levetiracetam) (Epilepsy) (Controls unexposed, sick), 2023 4 exposed to other treatment, sick controlsexposed to other treatment, sick controls 0.58[0.45; 0.74]4085,5760%NAStraub (Controls exposed to LTG) (Levetiracetam) (Epilepsy), 2026 Madley-Dowd_SE (Levetiracetam) (Controls exposed to LTG), 2024 Dreier (Levetiracetam) (Epilepsy) (Controls exposed to LTG), 2023 Huber-Mollema (Levetiracetam), 2019 40.510.01.0