Recommendation ID

Newly diagnosed seizures (focal and generalised) – monotherapy: How do the newer AEDs compare in efficacy to the standard AEDs in the treatment of newly diagnosed epilepsy?

  • Focal seizures: carbamazepine, eslicarbazepine acetate, lacosamide, lamotrigine, levetiracetam, pregabalin and zonisamide.

  • Generalised seizures: lamotrigine, levetiracetam, sodium valproate and zonisamide.

Any explanatory notes
(if applicable)

Levetiracetam and other AEDs licensed for the treatment of focal and generalised seizures since publication of the original NICE guideline on epilepsy in 2004 have not been evaluated as first-line monotherapy.

The research should include:

  • a prospective randomised controlled trial

  • all age groups

  • subgroup analyses on seizure types and syndromes

  • primary outcome of seizure freedom

  • secondary outcomes, including seizure reduction, quality of life and cognitive outcome

  • an attempt to obtain data on pharmaco-resistance.

Source guidance details

Comes from guidance
Epilepsies: diagnosis and management
Date issued
January 2012

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 31/05/2021