Integrated use of old and new antiepileptic drugs

Three new antiepileptic drugs have been approved for use in the USA in the past year and a half and several others are available in Europe and Japan. Each of these drugs has been efficacious against partial seizures without or with secondary generalization and some may also be efficacious against primary generalized seizures. None of the new drugs appears to be a quantum leap in therapy over the others that are already available. How these new drugs will be integrated into a rational scheme for the treatment of individuals with epilepsy remains to be determined. Side-effect profiles, pharmacokinetic issues, and cost will likely be significantly issues.