Antiepileptic drug treatment: new drugs and new strategies

Document Type

Article

Abstract

PURPOSE OF REVIEW: Selection of the ideal antiepileptic drug (AED) for an individual patient can be a daunting process. Choice of treatment should be based on several factors, including but not limited to epilepsy classification, AED mechanism of action, AED side-effect profile, and drug interactions. Special consideration must be given to populations such as women, older adults, patients with other medical comorbidities, and patients who are newly diagnosed. RECENT FINDINGS: Head-to-head trials between AEDs in newly diagnosed patients rarely demonstrate that one AED is more or less effective. The second-generation drugs, lamotrigine, topiramate, oxcarbazepine, zonisamide, and levetiracetam, have undergone head-to-head trials confirming similar efficacy and equal or better tolerability than standard drugs in focal epilepsy. SUMMARY: A thoughtful approach to the AED selection process must factor in data from clinical AED trials as well as a variety of patient characteristics and confounding factors. When neurologists apply an individualized approach to AED drug selection for their patients, they can find an effective and well-tolerated drug for most patients.

Medical Subject Headings

Adolescent; Aged; Anticonvulsants (therapeutic use); Epilepsy (drug therapy); Female; Humans; Male; Middle Aged

Publication Date

6-1-2013

Publication Title

Continuum (Minneapolis, Minn.)

E-ISSN

1538-6899

Volume

19

Issue

3 Epilepsy

First Page

643

Last Page

55

PubMed ID

23739102

Digital Object Identifier (DOI)

10.1212/01.CON.0000431380.21685.75

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