New antiepileptic drugs

Ten new antiepileptic drugs have been introduced in France over the past 15 years. Use of three of them is now restricted, because of either severe side effects identified after their approval for clinical practice or a poor efficacy/tolerability profile. Seven new antiepileptic drugs offer patients substantial improvements over older drugs in ease of use: they are better tolerated, with less frequent adverse effects and many fewer pharmacokinetic interactions. The efficacy of the new antiepileptic drugs is not superior to that of the first-generation antiepileptic drugs for patients with partial epilepsy Nor is the efficacy of any one of the new drugs superior to that of any of the others. The choice of an antiepileptic drug is thus based on several rules. It must be adopted to the patient's specific epileptic syndrome. Some antiepileptic drugs have a narrow spectrum of efficacy and may exacerbate seizures if they are not correctly prescribed. The choice must also be based on the patient's characteristics, in term of age, sex, comorbid conditions, and use of other medications.