Kiiski R, Basnyat P, Raitanen J, et al. - In daily clinical use, a reduction in the use of valproate has been observed with the simultaneous increased use of alternative antiseizure medications (ASMs) relative to previous study. Reducing use of valproate in women with epilepsy (WWE) did not elevate the risk of seizure recurrence; thus, valproate alternatives could be considered as first-line ASMs for WWE. Overall, patients with idiopathic generalized epilepsy (IGE) showed good clinical results with valproate or other broad-spectrum ASMs as monotherapy.

• This is a retrospective analysis of records of 263 IGE patients (166 females and 97 males) treated at Tampere University Hospital between 1 January 2009 and 31 December 2018.

• Among participants, 72.6% remained seizure free, and seizure control did not differ between genders (OR 1.25).

• The use of valproate in men was more frequent than in women while females used lamotrigine and levetiracetam more frequently than males.

• Lamotrigine and levetiracetam were consumed particularly as monotherapy in WWE, and mostly as a component of combination therapy in men.

• Valproate alternatives were equally effective as valproate when employed in monotherapy in adults.

• Valproate continued to be the most used ASM in the pediatric subgroup.