New Research in Pharmacologic Decision-making in the Treatment of Focal Epilepsy— A Critical Comparison of Antiepileptic Drugs

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In the peer-reviewed journal US Neurological Review, Selim R Benbadis, Hermann Stefan, Diego Morita, Bassel Abou-Khalil and R Edward Hogan discuss the Pharmacologic Decision-making in the Treatment of Focal Epilepsy— A Critical Comparison of Antiepileptic Drugs

Generalized Electroencephalogram  Onset for the First Generalized Tonic– Clonic Seizure

Generalized Electroencephalogram Onset for the First Generalized Tonic– Clonic Seizure

While seizures in newly diagnosed patients are often controlled with a single antiepileptic drug (AED), the estimated 30–40% of patients who are resistant to monotherapy could benefit from a combination of two or more carefully selected AEDs.

Physicians who treat patients with epilepsy must balance many factors when selecting the appropriate treatment for an individual patient, including seizure type, concomitant antiepileptic drug (AED) therapy, age, comorbid conditions, and even insurance coverage. Optimal management of seizures is further complicated by a continuously increasing pool of AEDs. As seizure type is a main factor in AED selection, this review will provide an evidence-based guide for physicians treating focal epilepsy.

This includes a summary of efficacy, safety, and tolerability data from randomized clinical trials as well as findings related to rational polypharmacy, drug–drug interactions, comorbidities, drug administration (titration, dosing, formulation), US Food and Drug Administration (FDA)-approved indications, and cost. Following the review are four case reports that provide real-life examples of clinical challenges physicians face, particularly when dealing with special populations, which highlight the decision-making process entailed when determining the best course of treatment for patients with epilepsy.

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Barney Kent
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