Moderne Pharmakotherapie Erwachsener

The much awaited guideline “First epileptic seizure and epilepsies in adults” of the German Neurological Society and the German Society of Epileptology were finally published in 2023. These recommendations, carefully developed through a consensus process by an expert group, largely cover the current literature and practical evidence. However, consensus-based guidelines have the methodological drawback that, although they are based on current evidence, the recommendations are ultimately made by consensus, which may be correct in consideration of the facts and the experience of the experts. A further problem of consensus-based guidelines results from contradictory or less established data and information from the literature so that the concluding guidelines ultimately remain vague. Despite the encouraging therapeutic developments concerning epilepsy surgery, neurostimulation or dietary treatments, antiseizure drug therapy still remains the gold standard for epilepsy therapy. New antiseizure medications along with high-class studies on safety and tolerability of established antiseizure medications have helped to improve antiseizure drug therapies. This review article summarizes the current state of the art of antiseizure drug treatment considering and discussing some aspects of the recently published guidelines.