Monotherapy and polypharmacy

The availability of many new antiepileptic drugs (AEDs) with novel mechanis ms of action has made polypharmacy, using combinations of AEDs with differi ng mechanisms, a viable alternative. The concept of monotherapy in epilepsy is relatively new, having attained widespread use only during the past few decades, and replacing irrational use of combinations of AEDs. In intracta ble epilepsy, however, monotherapy is often unsuccessful in achieving compl ete control, and skilled use of AEDs with differing mechanisms may provide better results. Monotherapy remains the treatment method of choice for new- onset epilepsy, but if control is not achieved, rational combinations shoul d be considered. Most critical to successful treatment of epilepsy is the c orrect identification of the epileptic syndrome.