Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new onset epilepsy [RETIRED]: Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society

J. A. French; A. M. Kanner; J. Bautista; B. Abou-Khalil; T. Browne; C. L. Harden; W. H. Theodore; C. Bazil; J. Stern; S. C. Schachter; D. Bergen; D. Hirtz; G. D. Montouris; M. Nespeca; B. Gidal; W. J. Marks; W. R. Turk; J. H. Fischer; B. Bourgeois; A. Wilner; R. E. Faught; R. C. Sachdeo; A. Beydoun; T. A. Glauser

doi:10.1212/01.WNL.0000123693.82339.FC

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Abstract

Objective: To assess the evidence demonstrating efficacy, tolerability, and safety of seven new antiepileptic drugs (AEDs) (gabapentin, lamotrigine, topiramate, tiagabine, oxcarbazepine, levetiracetam, and zonisamide—reviewed in the order in which these agents received approval by the US Food and Drug Administration) in the treatment of children and adults with newly diagnosed partial and generalized epilepsies.

Methods: A 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 until September 2002, with selected manual searches up until 2003.

Results: There is evidence either from comparative or dose-controlled trials that gabapentin, lamotrigine, topiramate, and oxcarbazepine have efficacy as monotherapy in newly diagnosed adolescents and adults with either partial or mixed seizure disorders. There is also evidence that lamotrigine is effective for newly diagnosed absence seizures in children. Evidence for effectiveness of the new AEDs in newly diagnosed patients with other generalized epilepsy syndromes is lacking.

Conclusions: The results of this evidence-based assessment provide guidelines for the prescription of AEDs for patients with newly diagnosed epilepsy and identify those seizure types and syndromes where more evidence is necessary.

This guideline is retired. The recommendations and conclusions are no longer considered valid and no longer supported by the AAN. Retired guidelines should be used for historical reference only. Please see AAN current guidelines here: https://www.aan.com/policy-and-guidelines/guidelines/.

Footnotes

↵*Chair.
↵†Co-Chair.

Received September 3, 2003.
Accepted in final form January 24, 2004.

Letters: Rapid online correspondence

Reply to Krauss
Jacqueline A. French, MD, Co-Chair of the Quality Standards Subcomittee, AAN, Hospital of the University of PA, 3400 Spruce St, Dept. of Neurology Ctr, Philadelphia, PA 19104kathy_pieper@urmc.rochester.edu
Submitted August 16, 2004
Efficacy and tolerability of the new antiepileptic drugs: Treatment of new onset epilepsy
Gregory L Krauss, Department of Neurology, The Johns Hopkins University, 600 N. Wolfe Street, Meyer 2-147, Baltimore, MD 21287gkrauss@jhmi.edu
Submitted August 16, 2004
Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new onset epilepsy
Robert G. Holloway, University of Rochester School of Medicine, 1351 Mt. Hope Avenue, Suite 223, Rochester, NY 14620robert.holloway@ctcc.rochester.edu
Submitted July 29, 2004
Reply to Holloway
Jacqueline French, Co-Chair of the Quality Standards Subcommittee, AAN,, Univeristy of PA, 3400 Spruce St., Philadelphia, PA 19104frenchj@mail.med.upenn.edu

Andres Kanner, MD and Gary Gronseth, MD
Submitted July 29, 2004

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Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new onset epilepsy [RETIRED]

Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society

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Report of the Therapeutics and Technology Assessment Subcommittee and Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society

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