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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

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Callaghan 1985 {published data only}
  • Callaghan N, Kenny RA, O'Neill B, Crowley M, Goggin T. A prospective study between carbamazepine, phenytoin and sodium valproate as monotherapy in previously untreated and recently diagnosed patients with epilepsy. Journal of Neurology, Neurosurgery and Psychiatry 1985;48:639-44.
Craig 1994 {published data only}
Czapinski 1997a {unpublished data only}
  • Czapinski P, Terczynski A, Czapinska E. Randomised 36-month comparative study of valproic acid, phenytoin, phenobarbital and carbamazepine efficacy in patients with newly diagnosed epilepsy with partial complex seizures. Epilepsia 1997;38 (Suppl 3):42.
De Silva 1996 {published data only}
  • De Silva M, MacArdle B, McGowan M, Hughes E, Stewart J, Neville BGR, et al. Randomised comparative monotherapy trial of phenobarbitone, phenytoin, carbamazepine, or sodium valproate for newly diagnosed childhood epilepsy. Lancet 1996;347:709-13.
Forsythe 1991 {published data only}
  • Forsythe I, Butler R, Berg I, McGuire R. Cognitive impairment in new cases of epilepsy randomly assigned to carbamazepine, phenytoin and sodium valproate. Developmental Medicine and Child Neurology 1991;33:524-34.
Heller 1995 {published data only}
  • Heller AJ, Chesterman P, Elwes RDC, Crawford P, Chadwick DW, Johnson AL, et al. Phenobarbitone, phenytoin, carbamazepine, or sodium valproate for newly diagnosed adult epilepsy: a randomised comparative monotherapy trial. Journal of Neurology, Neurosurgery, and Psychiatry 1995;58:44-50.
Ramsay 1992 {published data only}
  • Ramsay RE, Wilder BJ, Murphy JV, Holmes GL, Uthman B, Slater J, et al. Efficacy and safety of valproic acid versus phenytoin as sole therapy for newly diagnosed primary generalized tonic-clonic seizures. Journal of Epilepsy 1992;5(1):55-60.
Rastogi 1991 {published data only}
  • Rastogi P, Mehrotra TN, Agarwala RK, Singh VS. Comparison of sodium valproate and phenytoin as single drug treatment in generalised and partial epilepsy. Journal of the Association of Physicians of India 1991;39(8):606-8.
Shakir 1981 {published data only}
Thilothammal 1996 {published data only}
  • Thilothammal N, Banu K, Ratnam RS. Comparison of phenobarbitone, phenytoin with sodium valproate: randomized, double-blind study. Indian Pediatrics 1996;33:549-55.
Turnbull 1985 {published data only}
  • Turnbull DM, Howel D, Rawlins MD, Chadwick DW. Which drug for the adult epileptic patient: phenytoin or valproate?. British Medical Journal 1985;290:815-9.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Berg 1993 {published data only}
  • Berg I, Butler A, Ellis M, Foster J. Psychiatric aspects of epilepsy in childhood treated with carbamazepine, phenytoin or sodium valproate: a random trial. Developmental Medicine and Child Neurology 1993;35:149-57.
Callaghan 1981 {published data only}
  • Callaghan N, O'Neill B, Kenny RA. A comparison between carbamazepine, phenytoin and sodium valproate as single drug treatment in epilepsy [abstract]. Irish Journal of Medical Science 1981;150(6):194.
Callaghan 1983 {published data only}
  • Callaghan N, Kenny RA, O'Neill B, Crowley M, Goggin T. A comparative study between carbamazepine, phenytoin and sodium valproate as monotherapy in previously untreated and recently diagnosed patients with epilepsy: a preliminary communication. British Journal of Clinical Practice 1983;27:7-9.
Callaghan 1984 {published data only}
  • Callaghan N, Kenny RA, O'Neill B, Crowley M, Goggin T. A comparative study of carbamazepine, sodium valproate and phenytoin as monotherapy in epilepsy: an updated report [abstract]. Irish Journal of Medical Science 1984;153(4):154.
Craig 1993 {published data only}
  • Craig IR, Tallis RC. The impact of sodium valproate and phenytoin on cognitive function in elderly patients: results of a single-blind comparative study.. Age and ageing 1993;22(Suppl 2):10.
Czapinski 1997b {published data only}
  • Czapinski P, Terczynski A, Czapinska E. Comparative study of valproic acid (VPA), phenytoin (PHT), phenobarbital (PB) and carbamazepine (CBZ) in patients with newly diagnosed epilepsy with partial complex seizures [abstract]. Journal of Neurology 1997;244(Suppl 3):S95-6.
Czapinski 1997c {published data only}
  • Czapinski P, Terczynski A, Czapinska E. Randomized 36-month comparative study of valproic acid (VPA), phenytoin (PHT), phenobarbital (PB) and carbamazepine (CBZ) efficacy in patients with newly diagnosed epilepsy with partial complex seizures. Journal of the Neurological Sciences 1997;150(Suppl):S162-3.
Goggin 1984 {published data only}
  • Goggin T. A re-appraisal by control and seizure type of serum levels in previously untreated patients taking part in a prospective study comparing sodium valproate, phenytoin and carbamazepine as mono-therapy in epilepsy [abstract]. Irish Journal of Medical Science 1984;153(4):154.
Goggin 1986 {published data only}
  • Goggin T, Casey C, Callaghan N. Serum levels of sodium valproate, phenytoin and carbamazepine and seizure control in epilepsy.. Irish Medical Journal 1986;79(6):150-6.
Jannuzzi 2000 {published data only}
  • Jannuzzi G, Cian P, Fattore C, Gatti G, Bartoli A, Monaco F, et al. A multicenter randomized controlled trial on the clinical impact of therapeutic drug monitoring in patients with newly diagnosed epilepsy. The Italian TDM Study Group in Epilepsy. Epilepsia 2000;41(2):222-30.
Kaminow 2003 {published data only}
  • Kaminow L, Schimschock JR, Hammer AE, Vuong A. Lamotrigine monotherapy compared with carbamazepine, phenytoin, or valproate monotherapy in patients with epilepsy. Epilepsy and Behaviour 2003;4(6):659-66.
Sabers 1995 {published data only}
  • Sabers A, Møller A, Dam M, Smed A, Arlien-Søborg P, Buchman J, et al. Cognitive function and anticonvulsant therapy: effect of monotherapy in epilepsy. Acta Neurologica Scandinavica 1995;92(1):19-27.
Schmidt 2007 {published data only}
Shakir 1980 {published data only}
  • Shakir RA. Sodium valproate, phenytoin and carbamazepine as sole anticonvulsants. Royal Society of Medicine International Congress and Symposium 1980;30:7-16.
Tallis 1994a {published data only}
  • Tallis R, Craig I, Easter D. Multicentre comparative trial of sodium valproate and phenytoin in elderly patients with newly diagnosed epilepsy. Age and ageing 1994;23:S5.
Tallis 1994b {published data only}
  • Tallis R, Easter D. Multicenter comparative trial of valproate and phenytoin. Epilepsia 1994;35(Suppl 7):62.
Turnbull 1982 {published data only}
  • Turnbull DM, Rawlins MD, Weightman D, Chadwick DW. A comparison of phenytoin and valproate in previously untreated adult epileptic patients. Journal of Neurology, Neurosurgery and Psychiatry 1982;45(1):55-9.
Wilder 1983 {published data only}
  • Wilder BJ, Ramsay RE, Murphy JV, Karas BJ, Marquardt K, Hammond EJ. Comparison of valproic acid and phenytoin in newly diagnosed tonic-clonic seizures. Neurology 1983;33(11):1474-6.
Zeng 2010 {published and unpublished data}
  • Zeng K, Wang X, Xi Z, Yan Y. Adverse effects of carbamazepine, phenytoin, valproate and lamotrigine monotherapy in epileptic adult Chinese patients. Clinical Neurology and Neurosurgery 2010;112:291-5.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Bodensteiner 1988
Bourgeois 1987
Brasfield 1999
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Dinesen 1984
Easter 1997
Egger 1981
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Gladstone 1992
  • Gladstone DJ, Bologa M, Maguire C, Pastuszak A, Koren G. Course of pregnancy and fetal outcome following maternal exposure to carbamazepine and phenytoin: a prospective study. Reproductive Toxicology 1992;6(3):257-61.
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Marson 2007
  • Marson AG, Al-Kharusi AM, Alwaidh M, Appleton R, Baker GA, Chadwick DW, Cramp C, Cockerell OC, Cooper PN, Doughty J, Eaton B, Gamble C, Goulding PJ, Howell SJ, Hughes A, Jackson M, Jacoby A, Kellett M, Lawson GR, Leach JP, Nicolaides P, Roberts R, Shackley P, Shen J, Smith DF, Smith PE, Smith CT, Vanoli A, Williamson PR and the SANAD Study Group. The SANAD study of effectiveness of carbamazepine, gabapentin, lamotrigine, oxcarbazepine, or topiramate for treatment of partial epilepsy: an unblinded randomised controlled trial. The Lancet 2007;369(9566):1000-15.
Mattson 1985
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Meador 2008
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Morrow 2006
  • Morrow J, Russel A, Guthrie E, Parsons L, Robertson I, Waddell R, et al. Pregnancy outcomes in women with epilepsy: A systematic review and meta-analysis of published pregnancy registries and cohorts. Journal of Neurology, Neurosurgery and Neuropsychiatry  2006;77(2):193-8.
Novak 1999
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Troupin 1975
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Wallace 1997
  • Wallace H, Shorvon SD, Hopkins A, O'Donoghue M. National Society of Epilepsy Guidelines. London: Royal College of Physicians 1997.
Wilder 1983a
  • Wilder BJ, Karas BJ, Penry JK, Asconape J. Gastrointestinal tolerance of divalproex sodium. Neurology 1983;33:808-11.
Wilder 1995
  • Wilder BJ. Phenytoin: clinical use. Antiepileptic drugs. New York: Raven Press, 1995:339-44.
Williamson 2002

References to other published versions of this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
  4. References to other published versions of this review
Tudur Smith 2009
  • Tudur Smith C, Marson A, Williamson P. Phenytoin versus valproate monotherapy for partial onset seizures and generalized onset tonic-clonic seizures. Cochrane Database of Systematic Reviews 2009, Issue 4. [DOI: 10.1002/14651858.CD001769]