Safety and efficacy of standard and new antiepileptic drugs

Knowledge about the comparative safety and efficacy of standard and new ant iepileptic drugs (AEDs) is limited. Medications are selected on the basis o f seizure type and epilepsy syndrome, adverse effect profiles, and cost. Ho wever, there are few data comparing the efficacy of the new AEDs for the tr eatment of recent-onset versus refractory partial seizures, simple versus c omplex partial seizures, frontal versus temporal lobe seizures, or other re levant clinical types. Few studies compare new AEDs. The next best approach has been the use of meta-analyses and compilation of data from clinical tr ials, which allow interstudy comparisons to define broad and rough comparat ive estimates. These analyses, however, do not define clear differences in the safety and efficacy of the new AEDs because of differences in study pop ulations. The new AEDs have expanded our arsenal against seizures. As a gro up, they have favorable safety and efficacy profiles. The challenge is to d efine the differences in terms of clinical significance.