• Jacqueline A French, Andres M Kanner, Jocelyn Bautista, Bassel Abou-Khalil, Thomas Browne, Cynthia L Harden, William H Theodore, Carl Bazil, John Stern, Steven C Schachter, Donna Bergen, Deborah Hirtz, Georgia D Montouris, Mark Nespeca, Barry Gidal, William J Marks, William R Turk, James H Fischer, Blaise Bourgeois, Andrew Wilner, R Edward Faught, Rajesh C Sachdeo, Ahmad Beydoun, Tracy A Glauser, American Academy of Neurology Therapeutics and Technology Assessment Subcommittee, American Academy of Neurology Quality Standards Subcommittee, American Epilepsy Society Therapeutics and Technology Assessment Subcommittee, and American Epilepsy Society Quality Standards Subcommittee.
• Neurological Institute, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. jfrench@mail.med.upenn.edu
• Epilepsia. 2004 May 1; 45 (5): 410-23.

PurposeTo assess the evidence demonstrating efficacy, tolerability, and safety of seven new antiepileptic drugs (AEDs) [gabapentin (GBP), lamotrigine (LTG), topiramate (TPM), tiagabine (TGB), oxcarbazepine (OXC), levetiracetam (LEV), and zonisamide (ZNS)] in the treatment of children and adults with refractory partial and generalized epilepsies.MethodsA 23-member committee, including general neurologists, pediatric neurologists, epileptologists, and doctors in pharmacy, evaluated the available evidence based on a structured literature review including MEDLINE, Current Contents, and Cochrane Library for relevant articles from 1987 to March 2003.ResultsAll of the new AEDs were found to be appropriate for adjunctive treatment of refractory partial seizures in adults. GBP can be effective for the treatment of mixed seizure disorders, and GBP, LTG, OXC, and TPM for the treatment of refractory partial seizures in children. Limited evidence suggests that LTG and TPM also are effective for adjunctive treatment of idiopathic generalized epilepsy in adults and children, as well as treatment of the Lennox-Gastaut syndrome.ConclusionsThe choice of AED depends on seizure and/or syndrome type, patient age, concomitant medications, and AED tolerability, safety, and efficacy. The results of this evidence-based assessment provide guidelines for the prescription of AEDs for patients with refractory epilepsy and identify those seizure types and syndromes for which more evidence is necessary.

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