The National Institute for Clinical Excellence (NICE) has today issued guidance to the NHS in England and Wales on the use of newer drugs for the treatment of epilepsy in adults.
The NICE guidance recommends that the newer antiepileptic drugs (AEDs) [gabapentin, lamotrigine, levetiracetam, oxcarbazepine, tiagabine, topiramateand vigabatrin] should be used in the management of adults with epilepsy who have not benefited from treatment with the older AEDs (such as carbamazepine or sodium valproate), or where these are unsuitable (for example, because of contraindications, interactions with other drugs or where the person is a woman of childbearing potential).
The guidance further recommends that:
- Adults with epilepsy should be treated with just one antiepileptic drug where possible. If the first drug doesn’t prevent seizures, another can be tried.
- Adjunctive or combination therapy should only be considered when attempts at monotherapy have not resulted in seizure freedom.
- A careful assessment of the risks and benefits of treatment with individual AEDs should be undertaken, particularly in relation to women of childbearing potential.
- A person who has a seizure for the first time should see an epilepsy specialist as soon as possible, to find out exactly what type of epilepsy he or she has, so that the best treatment can be started.
- Treatment should be reviewed at regular intervals.
Epilepsy, which is a neurological disorder characterised by unprovoked recurring seizures, is the most common serious neurological condition in the UK with an estimated 400,000 people in England and Wales affected by it.