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Choosing the Right Aed - Different Seizures, Different Drugs

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Dr Sudhindra Aroor, Bengaluru    15 January 2018

  1. Before starting any aed: Confirmation of seizure(s), classify the epilepsy (seizure type, syndrome), rule out other.
  2. Starting of AEDs: Start first-line drug at low dose and gradually optimize until seizures stop; if seizures persist, review the diagnosis and etiology; if there is definite seizure, then plan second monotherapy or go for rational polytherapy.
  3. AED consideration: Numerous variables should be considered including – AED specific variables (seizure- or epilepsy-syndrome, efficacy, adverse effects, pharmacokinetics, formulations, and so on), patient-specific variables (genetic background, sex, age, comorbidities, socioeconomic status), nation-specific variables (AED availability, AED cost); AEDs as a clinical test for confirming a diagnosis of epilepsy has no justification.

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