Antiepileptic drugs for the elderly
Using the old to focus on the new
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Over the past decade, eight new antiepileptic drugs have been approved for patients with epilepsy in the United States, significantly expanding treatment options. The majority of data on these drugs derive from randomized controlled trials performed during the process of drug approval. These studies have focused on adjunctive therapy in refractory patients. The results show us that a drug is safe and effective, but fail to address clinical utility in broader populations of people with epilepsy, including those with newly diagnosed epilepsy. More importantly, we lack comparative data to inform choice relative to standard therapies currently accepted as first choice treatment.
The study by Rowan et al.1 in this issue of Neurology addresses some of the knowledge gaps and follows on from two previous VA cooperative studies, performed in the 1980s and 1990s, of head-to-head comparison of commonly used antiepileptic drugs, in patients with newly diagnosed epilepsy.2,3 In this new VA cooperative study, the existing …
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