A Systematic Review Of Antiepileptic Drugs For New Onset Epilepsy Treatment In Elderly Exclusively

Back ground:Elderly are more prone to develop epilepsy compared with younger people. Due to physical and healthy condition difference, the antiepileptic drugs utility in elderly may be more difficult. To prescribe suitable anticonvulsants in elderly is very important; however, there is still no consensus in anticonvulsant utility in this group of patients.Purpose:To evaluate the comparable safety, efficacy and healthy quality of life of different antiepileptic drugs used in elderly, we decided to conduct a systematic review.Methods:We searched and screened studies in Pubmed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) centre and the International Standard Randomised Controlled Trial Number (ISRCTN) register, as well as references of some important studies. Randomized clinical trails (RCTs) satisfied the defined criteria were included. The screening of clinical trails and data extraction were conducted by two reviewers independently. The primary outcome measures of review were:time to withdrawal and retention rate, seizure free rate post randomization, adverse events and healthy related quality of life. Existing variety of clinical methodology heterogeneity of trails, we didn't pool data for meta-analysis. After evaluating the quality of included studies, we summarized the information extracted from three RCTs.Findings:We identified only four articles covering three RCTs which were conducted in UK, USA and another one in a Norway predominated multicentre. The quality of three included RCTs was moderate to sufficient. The summarized information show that the new generation agent lamotrigine (LTG and gabapentin (GBP) are prone to with better tolerant profile and they are not different significantly on efficacy compared with conventional anticonvulsants carbamazepine (CBZ).Significance:There is not enough evidence to confirm that which antiepileptic drug is safer and more effective than another one for epilepsy treatment in elderly. But we could draw a cautious conclusion that CBZ, LTG and GBP could be taken as the initial options for epilepsy treatment in elderly. More long term, blinded, randomized anticonvulsants controlled clinical trails of epilepsy treatment in elderly are urgently needed; they should involve new and traditional antiepileptic drugs treatments.