Trials in the elderly

Epilepsy in the elderly differs from that in younger people in several respects. The incidence of seizures increases sharply with age and the seizures are more often symptomatic of underlying brain disease. The handling of antiepileptic drugs (AEDs) may be impaired by diminishing hepatic and renal function as age advances, and the pharmacodynamic response to drug therapy may be altered. In consequence, the elderly are more likely to experience adverse drug effects. Whether their seizures respond to drug treatment in a different way from younger patients is uncertain, but there are, nevertheless, convincing arguments for clinical trials being undertaken specifically in this population during the Phase II/IV development programme.