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Monotherapy versus Polytherapy in Epilepsy: a Framework for Patient Management

Published online by Cambridge University Press:  18 September 2015

J.H. Schneiderman
J.H. Schneiderman*
Affiliation:
Division of Neurology and Department of Physiology, University of Toronto and Wellesley Hospital, Toronto
*
Room 1116 E.K. Jones Building, Wellesley Hospital, 160 Wellesley Street, E., Toronto, Ontario, Canada M4Y 1J3
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Abstract:

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The long-standing debate between proponents of monotherapy and those of polytherapy for treatment of epilepsy has been rekindled by the recent development of several new antiepileptic drugs. The likelihood of improved seizure control on polytherapy must be weighed against the risk of increased side effects, complex drug interactions and cost. Providing maximal seizure control while avoiding overtreatment is a challenge which requires an ongoing critical evaluation of each patient's management. This review provides a framework for decision-making by considering issues affecting the choice between monotherapy and polytherapy in five clinical situations: 1) newly diagnosed epilepsy; 2) seizures on monotherapy; 3) seizures controlled on polytherapy; 4) not controlled on polytherapy; 5) change in medical condition.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 25 , Issue S4 , November 1998 , pp. S9 - S13
Copyright
Copyright © Canadian Neurological Sciences Federation 1998

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