A Comparative overview of Older Vs Newer Antiepileptic Medications (AEDs)

Abstract

For many years, antiepileptic medications (AEDs) have been the mainstay of epilepsy treatment. Although they are well-established in clinical practice, older AEDs like phenytoin, carbamazepine, and valproate have a number of limitations. These include complex pharmacokinetic interactions brought on by enzyme stimulation, a greater risk of teratogenicity, bone loss, and neuropsychiatric adverse effects. On the other hand, more recent AEDs with better safety profiles include levetiracetam, lamotrigine, oxcarbazepine, and lacosamide. They are less likely to cause drug-drug interactions, have fewer negative effects on cognition and psychiatry, and are typically better tolerated. These benefits make them especially appropriate for older people and those who need polypharmacy due to comorbidities. Newer AEDs frequently have higher prices and less long-term safety evidence, despite these advantages. For example, levetiracetam is an effective medication, but dosing tactics might affect its acceptability; slower titration and lower doses reduce adverse effects.