Androsova G, et al. – The physicians conducted this study to compare the effectiveness of the antiepileptic drugs (AEDs) in patients with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE–HS), also reported the retention, efficacy, and tolerability. They found no clear advantage of newer vs. older AEDs. The outcomes provided useful insights into AED retention, efficacy, and adverse drug reaction (ADR) rates in patients with MTLE–HS.

• The physicians gathered clinical data from a European database of patients with epilepsy.
• Retention, 12-month seizure freedom, and adverse drug reaction (ADR) rates for the 10 most commonly used AEDs in patients with MTLE-HS were estimated.

• The physicians included 767 patients with a total of 3,249 AED trials.
• They observed the highest 12-month retention rates with carbamazepine (85.9%), valproate (85%), and clobazam (79%).
• 12-month seizure freedom rates varied from 1.2% for gabapentin and vigabatrin to 11% for carbamazepine.
• They found highest response rates for AEDs that were prescribed as initial treatment and lowest for AEDs that were used in a third or higher instance.
• In 47.6% of patients, ADRs were reported, with the highest rates observed with oxcarbazepine (35.7%), topiramate (30.9%), and pregabalin (27.4%), and the lowest rates with clobazam (6.5%), gabapentin (8.9%), and lamotrigine (16.6%).
• Lethargy and drowsiness, dizziness, vertigo and ataxia, and blurred vision and diplopia were the most commonly reported ADRs.