Older medications for epilepsy obtain better control but have more adverse effects
Research Activities, February 2012, No. 378
A new evidence review from the Agency for Healthcare Research and Quality (AHRQ) evaluates the effectiveness and risks of antiepileptic medications. Among the findings: the older drug carbamazepine had advantages in epilepsy control over newer antiepileptic medications as a class, but had more adverse effects. In addition, older drugs, valproic acid and phenytoin, provided similar epilepsy control as newer antiepileptic medications, but adverse events occurred more often with them. However, these adverse events did not significantly increase the risk of medication withdrawals.
Approximately one to three percent of people in the United States will develop epilepsy over the course of their lives. Epilepsy begins most commonly during the first 9 years of life, plateaus over the next 30 years, dips in patients 40 to 59 years of age, and then rises again in the elderly. Research review authors found a lack of evidence to support substantive differences in terms of benefits or harms associated with the use of an innovator versus generic treatments.
This report, Comparative Effectiveness of Medications in Patients with Epilepsy, and many other resources for evidence-based decisionmaking are available on the AHRQ's Effective Health Care Program Web site.