Antiepileptic drug monotherapy: the initial approach in epilepsy management.

Current Neuropharmacology
Erik K St LouisThomas Bramley

Abstract

Antiepileptic drug (AED) monotherapy is the preferred initial management approach in epilepsy care, since most patients may be successfully managed with the first or second monotherapy utilized. This article reviews the rationale and evidence supporting preferential use of monotherapy when possible and guidelines for initiating and successfully employing AED monotherapy. Suggested approaches to consider when patients fail monotherapy include substituting a new AED monotherapy, initiating chronic maintenance AED polytherapy, or pursuit of non-pharmacologic treatments such as epilepsy surgery or vagus nerve stimulation. Reducing AED polytherapy to monotherapy frequently reduces the burden of adverse effects and may also improve seizure control. AED monotherapy remains the optimal approach for managing most patients with epilepsy.

Citations

Jun 5, 2012·Current Treatment Options in Neurology·Paul W Shepard, Erik K St Louis
Jul 26, 2011·Annals of Neurology·Matthias PreusserRoger Stupp
Sep 16, 2015·Drugs·James E Frampton
Apr 9, 2016·Drugs·Matt Shirley, Sohita Dhillon
May 6, 2015·Clinical Neurology and Neurosurgery·Genevieve EningChristopher Brenke
Mar 16, 2018·Acta Neurologica Scandinavica·V VillanuevaJ Serratosa
May 21, 2020·Acta Neurologica Scandinavica·Edgar SchuckZiad Hussein
May 1, 2021·Brain Sciences·James Brian RomaineJosé María Manzano Crespo
Jul 7, 2021·Epilepsy & Behavior : E&B·Sara CasciatoGiancarlo Di Gennaro

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