Second-generation antiepileptic medications in children: efficacy and cognitive effects

This paper is from the perspective of a user (prescriber) of antiepileptic medications in children who is attempting to practice evidence-based medicine. This is a review of published data comparing antiepileptic efficacy and cognitive effects from only randomized comparative trials. Data are almost nonexistent in young children, although adolescents are frequently included in the adult trials presented. These studies are inevitably flawed and the ideal study is suggested, but will in reality, never be performed. The review provides enough detail of previous studies so that the reader considering future antieplileptic drug trials can recognize how to avoid many of the problems in an era requiring proof of claims. Comparative studies will allow the supplier of the product (the physician) to make rational choices that can only improve market share.