New drug treatments for epilepsy

After the introduction of valproate in 1973, excluding benzodiazepines, there was a 19 year gap before the introduction of vigabatrin, the first in a series of new antiepileptic drugs to be developed and licensed. At the time of writing gabapentin, lamotrigine, oxcarbazepine, tiagabine, and topiramate have a licence in the United Kingdom. Zonisamide and levetiracetam are licensed in some countries outside the United Kingdom. In this article, we review some of the evidence for the eVectiveness and tolerability of these new drugs. We also attempt to draw attention to lessons learned and the conflict between the needs of the pharmaceutical industry, the clinician, and the patient.