Evidence map›Paper›PMID 41819499›Full record

ReviewArquivos de neuro-psiquiatria2026

Let's retire phenytoin! Levetiracetam as the first choice in the treatment of convulsive status epilepticus.

Luis Otávio Caboclo, Carol Ladeia Lopes Frota

Abstract readReview
In one paragraph

Review in Arquivos de neuro-psiquiatria, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. 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

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Luis Otávio CabocloHospital Israelita Albert Einstein, São Paulo SP, Brazil.ORCID 0009-0001-4956-5542
Carol Ladeia Lopes FrotaHospital Israelita Albert Einstein, São Paulo SP, Brazil.ORCID 0000-0002-7031-0464

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Status epilepticus (SE) is the most severe presentation of epilepsy. Most available data on the treatment of SE refers to the convulsive type. Treatment begins with an accurate diagnosis, followed by clinical stabilization and rapid administration of benzodiazepines (BZDs). Then, treatment continues with the use of an intravenous antiseizure medication (ASM). Phenytoin has been the preferred ASM as the second-line treatment of SE (after failure of BZDs to control seizures), although this choice was mostly guided by low-quality evidence. Recent evidence demonstrates that levetiracetam is at least as effective as phenytoin in the treatment of convulsive SE, both in adults and children. Moreover, growing evidence indicates that levetiracetam offers better tolerability and a more favorable safety profile. Therefore, in this Point of View, we argue that we should retire phenytoin in the treatment of convulsive SE, and levetiracetam should become the first choice of treatment.

Indexed as

AnticonvulsantsPhenytoinPiracetamStatus EpilepticusAdultHumansLevetiracetamTreatment OutcomeAnticonvulsantsLevetiracetamPhenytoinPiracetam

Identifiers

PMID41819499
PMCPMC12981960

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.