Several new antiepileptic drugs have become available recently. Since
seizures and epilepsy are common, primary care physicians are likely t
o encounter a patient who is taking one of these new medications. Succ
essful medical management of epilepsy requires a proper understanding
of medication half-life, indications, and side effects. Felbamate has
a broad spectrum of efficacy but is limited by side effects and idiosy
ncratic reactions. Fosphenytoin has the efficacy of phenytoin and offe
rs the advantage of intramuscular and intravenous dosing without the s
ignificant adverse effects associated with intravenous phenytoin; howe
ver, it is expensive. Gabapentin has minimal side effects and drug int
eractions yet has limited efficacy for seizures. Lamotrigine has broad
seizure efficacy but requires a slow adjustment to therapeutic levels
. Topiramate has minimal drug interactions, but therapy must be initia
ted slowly to avoid side effects. All of the new antiepileptics hold g
reat promise in the management of patients with recurrent seizures.