Epilepsy; Drug Treatment Principles

Antiepileptic drug selection is most dictated by the expectation that the drug will control or maximally prevent seizures. Evidence-based studies confirm that some drugs are superior for certain seizure types such as absence and myoclonic. Differences in efficacy for partial onset seizures are often modest, so the choice of drug may be decided by other factors such as expected adverse effects, comorbidities, pharmacokinetics, age, gender, and cost. No drug of choice exists for each seizure type. Rather careful individualized selection is indicated.