What guides the choice of an Anti Epileptic Drugs aside from spectrum of action

What guides the choice of an Anti Epileptic Drugs aside from spectrum of action

If an epilepsy syndrome is diagnosed, there are certain AEDs that are first line.

Otherwise, within the classes of broad- and narrow-spectrum medications, one medication is not clearly more efficacious than another; therefore, side effects and comorbidities are key reasons in choosing an AED.

Preferred Antiepileptic Drugs (AEDs) for Specific Epileptic Syndromes

Epileptic SyndromeAED of Choice
Childhood absence epilepsyEthosuximide > valproic acid/lamotrigine/levetiracetam
Juvenile myoclonic epilepsyValproic acid/levetiracetam/lamotrigine > topiramate/zonisamide
Lennox–Gastaut syndrome (LGS)Valproic acid/lamotrigine/felbamate/clobazam (carbamazepine/tiagabine can lead to status epilepticus)
LGS with drop seizuresRufinamide
West syndromeAdrenocorticotropic hormone (vigabatrin if tuberous sclerosis)

Courtesy of Zulfi Haneef

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