Larsson D, Baftiu A, Landmark CJ, et al. - In this population-based cohort study, researchers examined if survival varies in patients with post stroke epilepsy in correlation with choice of anti seizure medication (ASM).

• Analyzing individual-level data from linked registers on all adults in Sweden with acute stroke, and subsequent onset of epilepsy, researchers identified a total of 2,577 patients receiving continuous ASM monotherapy for inclusion in the study.

• Patients receiving treatment with lamotrigine had a significantly lower hazard of cardiovascular and all-cause death when compared with those treated with carbamazepine.

• A higher risk of cardiovascular and all-cause death was recorded for patients prescribed valproic acid when compared with those receiving treatment with carbamazepine and lamotrigine, and a lower risk of death from cardiovascular disease was recorded for those treated with levetiracetam vs those treated with carbamazepine.

• Overall findings suggest differences in survival between specific ASMs; it seems reasonable to use lamotrigine and levetiracetam as first-line treatment options for patients with post stroke epilepsy.