Levetiracetam is as effective as carbamazepine in newly diagnosed epilepsy

Evaluation of: Brodie MJ, Perucca E, Ryvlin P, Ben-Menachem E, Meencke HJ. Comparison of levetiracetam and controlled-release carbamazepine in newly diagnosed epilepsy. Neurology 6, 402-408 (2007). Despite the emergence of multiple antiepileptic drugs (AEDs) in the past decade, the task of choosing the right drug for monotherapy in patients with newly diagnosed epilepsy remains a precarious task. This is especially true when trying to choose a new AED over a more traditional agent. Much of this uncertainty stems from the fact that there are only a handful of studies that are able to demonstrate efficacy of a new drug over an older AED. While the newer drugs appear more favorable because of better tolerability, safety profiles and simple pharmacokinetics, many do not have an indication for monotherapy. Of course, this is further contingent upon the stringent limitations placed by regulatory bodies, such as the US FDA, who govern approval of AEDs for monotherapy. The current randomized study attempts to evaluate the efficacy of levetiracetam in monotherapy compared with controlled-release carbamazepine, a gold standard in patients with newly diagnosed epilepsy.