To compare and assess the evidence from randomized controlled trials on the efficacy and tolerability of valproic acid and phenytoin in status epilepticus.

There were 2 trials retrieved by means of computerized data search. The data was extracted with an intention to treat principle. The treatment effect was measured as odd's ratio between valproic acid and phenytoin.

A total of 168 patients were included in the 2 trials. There was no significant heterogeneity found between trials (Q value= 0.656, df 1.0, P value = 0.069). The combined odd's ratio for the responder rate was 0.501 in favor of valproic acid, with 95% confidence interval of 0.238 to 1.054. Cardiac and respiratory side effects were observed more in phenytoin while liver dysfunction was common in valproic acid.

Valproic acid is an effective and well tolerated medication for status epilepticus than phenytoin.