New anticonvulsants in the treatment of epilepsy in adolescents and adults suffering from an intellectual disability

The general recommendations contained in the neurology guidelines for patients suffering from epilepsy also apply to adolescents and adults suffering from both, epilepsy and intellectual disability. These guidelines recommend lamotrigine and levetiracetam as drugs of first choice for patients suffering from focal epilepsy; valproic acid is recommended as drug of first choice for patients suffering from generalized and unclassifiable epilepsy. The new antiepileptic drugs have roughly the same efficacy and adverse effects in patients suffering from epilepsy but not from an intellectual disability as in patients suffering from both, epilepsy and an intellectual disability. When dealing with patients who have difficulties to communicate, the adverse effects that may be caused by anticonvulsants. must be monitored closely. For patients suffering from both, epilepsy and an intellectual disability; laboratory investigations (for example, EEG, monitoring of the serum concentration of anticonvulsants) and neuropsychological assessments are more often required than for patients suffering from epilepsy only.