title: Antiepileptic drugs: from scientific evidence to clinical practice.
abstract: BACKGROUND
  Evidence-based medicine establishes guidelines for clinical decision-making in which priority is given to processes that have the highest level of evidence. Although these guidelines provide valuable general guidance, the information is partial, because oftentimes obtaining evidence on antiepileptic drugs is promoted by commercial expectations and not by clinical priorities. Furthermore, the guidelines tend to classify different types of epilepsy into large groups, often without contemplating the different syndromes. Expert opinions are subject to criticism on the basis of methodology and their authoritarian aspect, although they can supplement medical literature and advice on specific clinical situations quickly and efficiently.
  
  
  OBJECTIVE
  This review seeks to incorporate scientific evidence and expert opinion into drug treatment for epilepsy.
  
  
  METHODS
  To analyze this issue, a review of the literature was conducted by means of PubMed searches.
  
  
  CONCLUSIONS
  We have found that in all types of epilepsy [except in focal epilepsy in children where a new drug (oxcarbamazepine) is considered to be the first choice for initial treatment], classic drugs (valproic acid in idiopathic generalized epilepsy and carbamazepine in focal epilepsy) are recommended as long as there are no contraindications due to adverse effects or concomitant use of other drugs that interact with the antiepileptics. However, despite the general recommendations, it can be deduced from the studies and reflections on the subject that the decision as to whether to start treatment or not, as well as the drug of choice, must be made on a case-by-case basis, taking into account the patient's personal and social circumstances.
authors: Faculty of Medicine, Universidad Complutense, Hospital Universitario Clínico San Carlos, Madrid, Spain. ingmorales@hotmail.com
authors: Irene
authors: I
authors: García-Morales
authors: Jerónimo
authors: J
authors: Sancho Rieger
authors: Antonio
authors: A
authors: Gil-Nagel
authors: José Luís
authors: JL
authors: Herranz Fernández
mesh_terms: D000927:Anticonvulsants / Q000494:pharmacology* / Q000627:therapeutic use*; D035843:Biomedical Research; D004827:Epilepsy / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D017410:Practice Guidelines as Topic
chemical_list: D000927:Anticonvulsants