{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T18:23:46Z","timestamp":1780511026352,"version":"3.54.1"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The present study aimed to compare the safety and efficacy of sodium valproate, levetiracetam, and phenytoin in agitation control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods and Material<\/jats:title>\n                    <jats:p>This prospective observational study included 189 adult patients with traumatic brain injury (TBI) receiving sodium valproate, phenytoin, and levetiracetam. Agitation was monitored using the Richmond Agitation-Sedation Scale (RASS) at baseline and serially over seven days. The study evaluated the percentage of patients who experienced agitation-relief (A-R) following antiepileptic drugs, along with pattern of adverse events among the three groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sodium valproate (sod.v) demonstrated better efficacy with 85.7% of patients achieving A-R compared to 63.5% in levetiracetam (P\u2009=\u20090.016). The median time to achieve A-R was 3 days in sod.v and significantly lesser compared to 4 days in phenytoin (P\u2009=\u20090.04) and 5 days in levetiracetam (P\u2009=\u20090.0001). By day 4, 72% of patients in the sod.v achieved A-R, in contrast to 50% in the phenytoin and 31.7% in the levetiracetam group. The safety profile of sod.v and levetiracetam was more favorable with lesser occurrence of adverse events compared to phenytoin (P\u2009=\u20090.017).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>To our knowledge, this is the first pivotal evidence to compare antiepileptics for agitation control in post-traumatic brain injury patients. Our study demonstrated that patients receiving sodium valproate showed relatively greater and earlier improvement in agitation control, with an acceptable safety profile.<\/jats:p>\n                    <jats:p>The study proves the dual benefits of sod.v in post-TBI improving patient outcomes and alleviating mental strain on patients, and their families.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0350585","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T17:54:26Z","timestamp":1780509266000},"page":"e0350585","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing the safety and efficacy of sodium valproate, levetiracetam, and phenytoin in attenuating the severity of agitation in patients with post-traumatic brain injury: An observational 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