The treatment of epilepsy: an overview of clinical practices.

About 30% of patients with epilepsy remain refractory to medical management despite optimal use of conventional antiepileptic drugs. Seizure control for many patients is often achieved at the expense of adverse drug effects. The need for new drugs is obvious. After 15 years, three new antiepileptic drugs are now clinically available: felbamate, gabapentin, and lamotrigine. These drugs have undergone double-blind, controlled clinical trials for efficacy and safety in patients with predominantly simple, complex partial, and generalized tonic-clonic seizures. All of these new drugs will be used initially in a polypharmacy regimen.