Evidence map›Paper›PMID 41120802›Full record

SynthesisClinical pharmacokinetics2026

How is Levetiracetam Monotherapy Currently Monitored in Pregnancy? A Systematic Review.

Tessa Rademaker, Yeonkyung Goo, May Ching Soh, Dharmintra Pasupathy, Chong Wong, Andrew Bleasel, Jan-Willem Alffenaar

Erratum issuedAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Clinical pharmacokinetics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Tessa RademakerSchool of Pharmacy, Faculty of science, Utrecht University, Utrecht, The Netherlands.
Yeonkyung GooSydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, A15 Science Rd, Camperdown, NSW, 2006, Australia.
May Ching SohObstetric Medicine Department, Middlemore Hospital, Counties Manukau Health New Zealand, Auckland, New Zealand.
Dharmintra PasupathyWestmead Hospital, University of Sydney, Westmead, NSW, Australia.
Chong WongWestmead Hospital, University of Sydney, Westmead, NSW, Australia.
Andrew BleaselWestmead Hospital, University of Sydney, Westmead, NSW, Australia.
Jan-Willem AlffenaarSydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, A15 Science Rd, Camperdown, NSW, 2006, Australia. johannes.alffenaar@sydney.edu.au.ORCID 0000-0001-6703-0288

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLevetiracetam is commonly used as antiepileptic drug during pregnancy and has a well-established safety profile in that setting. Pregnancy-related pharmacokinetic changes may result in decreased levetiracetam levels and increased seizure frequency during pregnancy. Therapeutic drug monitoring (TDM) of levetiracetam levels may facilitate dose adjustment. Although levetiracetam TDM is widely used in pregnancy, robust guidelines are still lacking, resulting in heterogeneous use of TDM.

objectivesThe aim of this review was to provide insight into levetiracetam TDM strategies utilised during pregnancy.

methodsA systematic search up to 17 April 2025 was carried out using MEDLINE, Embase, APA PsycINFO, and Cochrane Central Register of Controlled Trials through Ovid. Studies were eligible for inclusion if data on levetiracetam dosing, concentrations, monitoring, efficacy, or safety during pregnancy were available. All articles were assessed for the risk of bias, and relevant data were extracted.

resultsThe ten studies included revealed significant variability in epilepsy monitoring during pregnancy, TDM strategies, and dose adjustments. An increase in seizure frequency during pregnancy was described. However, data on levetiracetam maternal and foetal safety were limited.

conclusionsThis review highlights the heterogeneity in levetiracetam TDM strategies in pregnancy. The pharmacokinetic changes during pregnancy require dose adjustments to maintain seizure control, but no standardised TDM protocol is available. Future research should focus on standardizing TDM strategies, validating target concentration thresholds, and assessing long-term maternal and foetal safety.

Indexed as

AnticonvulsantsDrug MonitoringEpilepsyLevetiracetamPregnancy ComplicationsFemaleHumansPregnancySeizuresAnticonvulsantsLevetiracetam

Identifiers

PMID41120802
PMCPMC12783189

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.