Colleran N, et al. – This systematic review aimed to ascertain the effect of anti–epileptic drugs (AED) for drug–resistant patients with idiopathic generalised epilepsy. With regard to 50% reduction and seizure freedom, the clinicians showed the efficacy of adjunctive anti–epileptic drugs. In all of the studies in the drug treatment groups, adverse events were identified but were consistent with previous studies of these drugs. Advanced studies were required to unequivocally establish the long–term efficacy and tolerability of anti–epileptic drugs for patients with drug–resistant idiopathic generalised epilepsy.

• The clinicians performed a systematic search of Medline, Cumulative Index to Nursing an Allied Health Literature (CINAHL), Cochrane Epilepsy Group Central Specialised Register, Cochrane Central Register of controlled Trials (CENTRAL), Embase and Lenus.
• They included 9 randomised controlled trials.
• For this study, all trials compared antiepileptic drugs to placebo.
• Outcome measures assessed were 50% or greater reduction in seizure, seizure freedom and adverse events.

• In this study, 7 trials reported a 50% or greater reduction in seizure frequency.
• This was statistically significant (p = < 0.00001) with a narrow confidence interval indicating that the overall this meta-analysis had reasonable power to detect an effect.
• It showed a significant statistical difference of seizure freedom occurring in the drug treatment group compared to placebo.
• The clinicians identified adverse events with each drug and were reported.
• However, there were methodological issues with the trials included.
• Using the risk of bias assessment from Rev Man 5.3 tool for all randomised controlled trials retrieved, quality appraisal was undertaken.