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of everyone affected by epilepsy

NHS watchdog supports use of new epilepsy medication

30 March, 2004

The National
Institute for Clinical Excellence
(NICE) has issued guidance to the National
Health Service 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, topiramate and
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
    age.
  • 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.

Campaigners who have been lobbying for more attention to be paid to
the particular needs of women with epilepsy welcome the guidance and
are hoping that it will lead to more women having access to the most
appropriate treatments.

Philip Lee, Chief
Executive of Epilepsy Action, said:

"We welcome
this guidance which allows clinicians to maintain the widest choice
in treatment options. As epilepsy is such an individual condition it
is
vital that patients have access to the most appropriate medication
and treatment programme.

"We are particularly
pleased that NICE have incorporated
some important issues, highlighted by Epilepsy Action, surrounding
the treatment of women with epilepsy. Our 'Women Matter' campaign
is calling for minimum standards of care to be established at a local
level and
we now have more evidence than ever to support this goal."