The role of polytherapy in the management of epilepsy: suggestions for rational antiepileptic drug selection

Alberto Verrotti, Renato Tambucci, Ludovica Di Francesco, Piero Pavone, Giulia Iapadre, Emma Altobelli, Sara Matricardi, Giovanni Farello, Vincenzo Belcastro

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Antiepileptic polytherapy may be indicated in patients experiencing drug-resistant epilepsy. To date, there are no evidence-based criteria on how to combine different antiepileptic drugs (AEDs) together, in order to obtain the best therapeutic response.Areas covered: This paper reviews the available data about the various associations of AEDs in patients undergoing polytherapy, focusing on the most effective and well-tolerated polytherapies. Moreover, some controversial aspects of this topic are addressed.Expert opinion: Nowadays, there are no guidelines on polytherapy in patients with epilepsy; thus, the management of pharmacoresistant epilepsy is still uncertain, except for valproate/lamotrigine combination, which seems to be the only one recommended. Data regarding mechanism of action, pharmacokinetics, tolerability, and, more importantly, the analysis of the valuable clinical studies of drug combinations can help physicians to choose the best and most effective AED association for each patient.

Original languageEnglish
Pages (from-to)167-173
Number of pages7
JournalExpert Review of Neurotherapeutics
Volume20
Issue number2
DOIs
Publication statusE-pub ahead of print - 2019
Externally publishedYes

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