Treatment with anti-epileptic drugs.
BACKGROUND
The principles of epilepsy management are accurate diagnosis coupled with education, lifestyle advice, and drug therapy. There are a large number of anti-epileptic drugs now available.


OBJECTIVE
This article deals with initial treatment, the role of the newer agents, and practical issues such as monitoring of therapy and the use of generic drugs. The difficult issues of when to stop therapy and management of epilepsy in pregnancy are highlighted.


CONCLUSIONS
Accurate seizure and syndrome diagnosis determines the optimal choice of medication. In most patients with new onset epilepsy, seizures can be easily controlled with lifestyle modification and medication. In general, valproate is first line treatment for generalised epilepsy and carbamazepine for partial epilepsies. New anti-epileptic drugs offer benefits in patients who are not controlled or intolerant of the older agents. Monitoring of therapy is primarily clinical; not necessarily requiring testing for serum levels or other blood tests.
Berkovic
Samuel F
SF
Epilepsy Research Centre and Department of Medicine, University of Melbourne, Austin Health, Victoria. s.berkovic@unimelb.edu.au
D000927:Anticonvulsants / Q000493:pharmacokinetics / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D016903:Drug Monitoring / Q000379:methods; D004827:Epilepsy / Q000188:drug therapy*; D005194:Family Practice / Q000379:methods; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D013810:Therapeutic Equivalency; D016896:Treatment Outcome
D000927:Anticonvulsants