Intervention Review

You have free access to this content

Phenytoin versus valproate monotherapy for partial onset seizures and generalised onset tonic-clonic seizures

  1. Sarah J Nolan1,*,
  2. Anthony G Marson2,
  3. Jennifer Pulman2,
  4. Catrin Tudur Smith1

Editorial Group: Cochrane Epilepsy Group

Published Online: 23 AUG 2013

Assessed as up-to-date: 16 JUL 2013

DOI: 10.1002/14651858.CD001769.pub2


How to Cite

Nolan SJ, Marson AG, Pulman J, Tudur Smith C. Phenytoin versus valproate monotherapy for partial onset seizures and generalised onset tonic-clonic seizures. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD001769. DOI: 10.1002/14651858.CD001769.pub2.

Author Information

  1. 1

    University of Liverpool, Department of Biostatistics, Liverpool, UK

  2. 2

    Institute of Translational Medicine, University of Liverpool, Department of Molecular and Clinical Pharmacology, Liverpool, Merseyside, UK

*Sarah J Nolan, Department of Biostatistics, University of Liverpool, Shelley's Cottage, Brownlow Street, Liverpool, L69 3GS, UK. sarah.nolan@liv.ac.uk.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 23 AUG 2013

SEARCH

[Figure 1]
Figure 1. Study flow diagram.
[Figure 2]
Figure 2. Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
[Figure 3]
Figure 3. Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
[Figure 4]
Figure 4. Time to withdrawal of allocated treatment

One participant randomised to phenytoin (PHT) and nine participants randomised to valproate (SV) had time to withdrawal of zero days and are therefore not included in "Number at Risk"
[Figure 5]
Figure 5. Time to withdrawal of allocated treatment - stratified by epilepsy type

One participant with generalised epilepsy randomised to phenytoin (PHT) and nine participants with generalised epilepsy randomised to valproate (SV) had time to withdrawal of zero days and are therefore not included in "Number at Risk"
[Figure 6]
Figure 6. Time to 12-month remission
[Figure 7]
Figure 7. Time to 12-month remission - stratified by epilepsy type
[Figure 8]
Figure 8. Time to six-month remission
[Figure 9]
Figure 9. Time to six-month remission - stratified by epilepsy type
[Figure 10]
Figure 10. Time to first seizure
[Figure 11]
Figure 11. Time to first seizure - stratified by epilepsy type
[Figure 12]
Figure 12. Time to withdrawal of allocated treatment - Ramsay 1992
[Analysis 1.1]
Analysis 1.1. Comparison 1 Phenytoin versus sodium valproate, Outcome 1 Time to withdrawal of allocated treatment.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Phenytoin versus sodium valproate, Outcome 2 Time to withdrawal of allocated treatment - stratified by epilepsy type.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Phenytoin versus sodium valproate, Outcome 3 Time to 12-month remission.
[Analysis 1.4]
Analysis 1.4. Comparison 1 Phenytoin versus sodium valproate, Outcome 4 Time to 12-month remission - stratified by epilepsy type.
[Analysis 1.5]
Analysis 1.5. Comparison 1 Phenytoin versus sodium valproate, Outcome 5 Time to six-month remission.
[Analysis 1.6]
Analysis 1.6. Comparison 1 Phenytoin versus sodium valproate, Outcome 6 Time to six-month remission - stratified by epilepsy type.
[Analysis 1.7]
Analysis 1.7. Comparison 1 Phenytoin versus sodium valproate, Outcome 7 Time to first seizure.
[Analysis 1.8]
Analysis 1.8. Comparison 1 Phenytoin versus sodium valproate, Outcome 8 Time to first seizure - stratified by epilepsy type.
[Analysis 1.9]
Analysis 1.9. Comparison 1 Phenytoin versus sodium valproate, Outcome 9 Time to first seizure - epilepsy type reclassified to uncertain for generalised and age of onset > 30 years.
[Analysis 1.10]
Analysis 1.10. Comparison 1 Phenytoin versus sodium valproate, Outcome 10 Time to first seizure - epilepsy type reclassified to partial for generalised and age of onset >30 years.