[Evidence based treatment of epilepsy].
OBJECTIVE
Evidence based medicine is becoming popular in all fields of medicine. Through systematic reviews, critical evaluation, and statistical strategies such as meta analysis it aids to take decisions in clinical practice. We revise the information on the treatment of epilepsy found in the main sources of evidence based medicine.


METHODS
After commenting some basic concepts such as systematic review, meta analysis, odds ratio, relative risk and numbers needed to treat, we describe the main primary, secondary and tertiary drug information sources with emphasis on sources of evidence based medicine. Some representative examples are given about the information on treatment of epilepsy found in the main sources of evidence based medicine such as TRIP, DARE, Cochrane Library, clinical practice guidelines, Clinical Evidence or Bandolier. Most clinical trials analyze the efficacy and tolerability of add on new antiepileptic drugs in partial refractory epilepsy. However, we found few trials on efficacy and tolerability of these drugs in monotherapy, in newly diagnosed partial epilepsy, on other types of epilepsy or in children. There are also few trials comparing the new antiepileptic drugs between them or in relation to the old ones.


CONCLUSIONS
Treatment of epilepsy is yet an art more than a science because clinical practice decisions depends on therapeutic habits and clinical expertise more than on the results emerging from randomized and controlled clinical trials. Large comparative trials are needed but relevant criteria of efficacy and validated procedures to evaluate quality of life, tolerability or cognitive function outcomes should be used in these trials.
Armijo
J A
JA
Servicio de Farmacología Clínica. Hospital Universitario Marqués de Valdecilla. Santander, Cantabria, España.
Sanchez
B
B
González
A B
AB
D000927:Anticonvulsants / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D016206:Databases, Bibliographic; D004346:Drug Information Services; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D015201:Meta-Analysis as Topic; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000927:Anticonvulsants