Various agents have been used for the treatment of epilepsy. Standard antiepileptics (AEDs) have been available in the United States for many years and although they continue to play an important role in the treatment of epilepsy, these agents have limitations. Many have a lack of efficacy, side effects or toxicities, or potentially cause interactions with other agents. While the mechanism of action for AEDs is still not entirely clear, most experts agree that it is related to ion channels and ultimately to the balance between neural inhibition and excitation. The ultimate goal of all AEDs is to either reduce excitation or promote inhibition. There is an opportunity for newer AEDs to be developed and marketed; these newer agents have the promise of fewer adverse effects and greater efficacy. A challenge for the new AEDs is to actually prevent the initiation of epileptiform activity and prophylactically suppress seizure induction.