Evaluation of efficacy, safety and tolerability of newer antiepileptic Drugs in patients of epilepsy

Introduction: Epilepsy is the most common neurological disorder. The conventional anti-epileptic
drugs (AEDs), used as first line agents, control seizures successfully in 70-80% of individuals.
Several new AEDs have been approved for epilepsy with the aim of improving seizure control,
tolerability and quality of life.
Objective: To evaluate the efficacy and safety of newer AEDs in epileptic patients.
Material and methods: A prospective study where 100 epileptic patients who were on treatment
since one year reporting to neurology OPD were included in the study.
Seizure freedom for minimum one year and >50% reduction in seizure frequency within one year
after initiating the treatment were taken as criteria for the efficacy of the AEDs. Appropriate
statistical tests were applied and p value <0.05 considered to be statistically significant.
Results: Carbamazepine & oxcarbazepine were the most commonly used conventional & newer
monotherapy respectively. Valproic acid & topiramate were most commonly used conventional &
newer AED respectively as a part of combination therapy.
We found more seizure freedom and >50% reduction in seizure frequency in patients on newer
monotherapy as compared to conventional monotherapy. In combination therapy, number of patients
with seizure freedom in conventional plus newer combination group were significantly more as
compared to conventional plus conventional combination group.
Though adverse drug reactions were little more with conventional AEDs, overall they were well
tolerated. While newer AEDs were almost 2 to 2.5 times costly as compared to conventional
monotherapy.
Conclusion: Newer AEDs can be considered for the treatment of epilepsy as they found to be more
effective, safe and better tolearable when used alone or in combination.