Choosing Old and New Antiepileptic Drugs in Epilepsy Treatment

Objective: According to recent studies old antiepileptic drugs used without alternative in the treatment of epilepsy, seems to leave their place to new antiepileptic drugs during last two decades. The present study aimed to investigate whether the results of those studies hold any truth in clinical practice. Patients and Methods: Medical records of patients that present to our clinic with the diagnosis of epilepsy between 2001 and 2007 were investigated retrospectively. Results: Data on 1358 patients were evaluated. Among them, 1120 (82%) patients had monotherapy and 238 (18%) patients had polytherapy. The results were grouped by initial treatment dates: 552 of 603 (86%) patients used old antiepileptic drugs and 92 (14%) used new antiepileptic drugs between 2000 and 2007; 467 of 483 (95%) patients used old antiepileptic drugs and 24 (5%) used new antiepileptic drugs between 1995 and 1999; 270 of 272 (99%) used old antiepileptic drugs and 3 (1%) used new antiepileptic drugs prior to 1994. Conclusion: When the patients that received monotherapy were grouped by initial treatment dates the rate of new antiepileptic drug use was 10%, although old antiepileptic drugs were still the first choice. There was a significant increase in the use of new antiepileptic drugs as adjuvant treatment in patients with polytherapy in the last years.