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These drugs are typically grouped by their mechanisms of action and therapeutic spectrum.\u00a0This article aims to educate non\u2010neurologists and medical students about the new frontiers in the pharmacology of ASDs and presents the current state of the literature on the efficacy and tolerability of these agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Randomized controlled trials, observational studies, and evidence\u2010based meta\u2010analyses of ASD efficacy and tolerability as initial monotherapy for epileptic seizures and syndromes were identified in PubMed, EMBASE, the Cochrane Library, and Elsevier Clinical Pharmacology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The choice of ASD varies primarily according to the seizure type. Practical guidelines for ASD selection in patients with new\u2010onset and drug\u2010resistant epilepsy were recently published. The guidelines have shown that the newer\u2010generation drugs, which have unique mechanistic and pharmacokinetic properties, are better tolerated but have similar efficacy compared with the older drugs. Several ASDs are effective as first\u2010line monotherapy in focal seizures, including lamotrigine, carbamazepine, phenytoin, levetiracetam, and zonisamide. Valproate remains the first\u2010line drug for many patients with generalized and unclassified epilepsies. However, valproate should be avoided, if possible, in women of childbearing potential because of teratogenicity. Toxicity profile precludes several drugs from use as first\u2010line treatment, for example, vigabatrin, felbamate, and rufinamide.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Antiseizure drugs have different pharmacologic profiles that should be considered when selecting and prescribing these agents for epilepsy. 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