Levetiracetam (Epilepsy) updated on 04-22-2025

ADHD (Attention deficit hyperactivity disorder): Diagnosis/Risk

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
R82954
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
R83042
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
R73237
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
R73238
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
R72261
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
R65402
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
R65410
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
R46410
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
S7308
R46411
Bromley (Levetiracetam), 2016 Maladaptive behavior: Attention (BASC) (5-9 years old) during pregnancy (anytime or not specified) retrospective cohort (registry) unexposed, sick Adjustment: No extrapolated (cont. endpoint) 0.86 [0.41;1.78] -/42   -/55 - 42
ref
Total 6 studies 1.03 [0.79;1.34] 2,101 5,792
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]1,11955620%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]-1742%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]5421,06119%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 Bromley (Levetiracetam), 2016Bromley, 2016 6 0.86[0.41; 1.78]-4212%ROB confusion: NAROB selection: NAROB classification: NAROB missing: NAROB mesure: NAROB reporting: NA Total (6 studies) I2 = 17% 1.03[0.79; 1.34]2,1015,7920.25.01.0ROB: 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; 6: Levetiracetam;

Sensitivity analysis

SubsetTE95% CIn casesn exposedkI2 Type of studies cohort studiescohort studies 1.03[0.79; 1.34]2,1015,79217%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 Bromley (Levetiracetam), 2016 6 case control studiescase control studies 0 Type of controls unexposed, sickunexposed, sick 1.04[0.79; 1.37]2,0965,76223%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 Bromley (Levetiracetam), 2016 5 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 0.80[0.39; 1.63]5720%NAHuber-Mollema (Levetiracetam), 2019 Bromley (Levetiracetam), 2016 2   - 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 extrapolated (cont. endpoint)extrapolated (cont. endpoint) 0.86[0.41; 1.79]-42 -NABromley (Levetiracetam), 2016 1 Partial overlappingPartial overlapping 0.99[0.58; 1.68]1,119556 -NAMadley-Dowd_SE (Levetiracetam) (Controls unexposed, sick), 2024 1 All studiesAll studies 1.03[0.79; 1.34]2,1015,79217%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 Bromley (Levetiracetam), 2016 60.15.01.0

Publication bias and p-hacking diagnosis

funnel plot
0.0-3.53.51.7910.000Straub (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), 2019Bromley (Levetiracetam), 2016

Asymetry test p-value = 0.9426 (by Egger's regression)

slope=-0.0178 (0.2309); intercept=0.0674 (0.8800); t=0.0766; p=0.9426

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 1.04[0.79; 1.37]2,1255,76223%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 Bromley (Levetiracetam), 2016 5 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