Seizure control: how to use the new antiepileptic drugs in older patients

Three new antiepileptic drugs--vigabatrin, gabapentin, and lamotrigine--provide alternatives in the management of older patients with refractory partial seizures. Each appears to have a unique mechanism of action. Clinical trials indicate that routine lab monitoring is not necessary for the safe and effective use of these drugs. They also do not induce liver enzymes or alter the metabolism of other antiepileptic drugs, thus minimizing the risk of interactions. Potential side effects of these agents include dizziness, somnolence, and other signs of CNS depression.