How rational is current anti-epileptic drug treatment?

The epilepsy community has often failed to recognise that, at present, anti-epileptic drug therapies are empirical rather than rational. Our current practice may be termed "rational prescribing" rather than "rational therapy". Significant recent improvements in the quality of the available empirical evidence, though welcome, cannot be considered as a substitute for a more scientific approach to epilepsy. The commitment to a molecular biological approach that is at the forefront of cancer and HIV research needs to be adopted by physicians treating people with epilepsy.