The pharmacological treatment of epilepsy in adults

Lancet Neurol 2011; 10: 446–56

Treatment decisions in epilepsy need to be individualised on the basis of careful analysis of the risk-benefi t ratio of
each available option. Key decision steps include the time at which antiepileptic drug treatment should be started,
which drug should be chosen for fi rst-line therapy, and which strategy is most appropriate for people who did not
respond to the initially prescribed drug. With more than 20 antiepileptic drugs currently available to treat epilepsy in
adults, opportunities to tailor drug therapy have never been greater, but optimum use of such a complex
armamentarium is a challenge even for the epilepsy specialist. Antiepileptic drug choice is primarily based on
evidence of effi cacy and eff ectiveness for the individual’s seizure type, but other patient-specifi c factors need to be
considered, including age, sex, childbearing potential, comorbidities, and concomitant medications.

 

 The pharmacological treatment of epilepsy in adults.pdf