Management of newly diagnosed epilepsy: a practical guide to monotherapy

With the emergence of several new antiepileptic drugs (AEDs) in recent years, choosing an agent to initiate monotherapy in newly diagnosed epilepsy has become increasingly complicated. We provide a succinct guide intended for general clinicians to assist in this clinical situation. General features of AEDs, differences between first- and second-generation drugs, and characteristics specific to each medication are discussed. The emphasis is on tailoring treatment to the individual patient with epilepsy because each case has specific features that must be accounted for, including the type of seizure and epilepsy, medication-specific characteristics, co-morbid conditions, drug-drug interactions, patient drug tolerance, and special population factors, all of which must be balanced and optimized when choosing initial therapy in this setting. Finally, this information is conveniently summarized in a set of tables and illustrated by way of case scenarios.