{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T20:42:31Z","timestamp":1790109751633,"version":"4.0.1"},"reference-count":25,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2018,7,1]],"date-time":"2018-07-01T00:00:00Z","timestamp":1530403200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Epilepsy Curr"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:p>Objective: To update the 2004 American Academy of Neurology (AAN) guideline for treating new-onset focal or generalized epilepsy (GE) with second- and third-generation antiepileptic drugs (AEDs). Methods: The 2004 AAN criteria was used to systematically review literature (January 2003 to November 2015), classify pertinent studies according to the therapeutic rating scheme, and link recommendations to evidence strength. Results: Several second-generation AEDs are effective for new-onset focal epilepsy. Data are lacking on efficacy in new-onset generalized tonic\u2013clonic seizures, juvenile myoclonic epilepsy, or juvenile absence epilepsy, and on efficacy of third-generation AEDs in new-onset epilepsy. Recommendations: Lamotrigine (LTG) should (Level B) and levetiracetam (LEV) and zonisamide (ZNS) may (Level C) be considered in decreasing seizure frequency in adults with new-onset focal epilepsy. LTG should (Level B) and gabapentin (GBP) may (Level C) be considered in decreasing seizure frequency in patients \u226560 years with new-onset focal epilepsy. Unless there are compelling adverse-effect\u2013related concerns, ethosuximide (ETS) or valproic acid (VPA) should be considered before LTG to decrease seizure frequency in treating absence seizures in childhood absence epilepsy (Level B). No high-quality studies suggest clobazam, eslicarbazepine, ezogabine, felbamate, GBP, lacosamide, LEV, LTG, oxcarbazepine, perampanel, pregabalin, rufinamide, tiagabine, topiramate, vigabatrin, or ZNS is effective in treating new-onset epilepsy because no high-quality studies exist in adults of various ages. A recent FDA strategy allows extrapolation of efficacy across populations; therefore, for focal epilepsy, eslicarbazepine and lacosamide (oral only for pediatric use) as add-on or monotherapy in persons \u22654 years old and perampanel as monotherapy received FDA approval.<\/jats:p>","DOI":"10.5698\/1535-7597.18.4.260","type":"journal-article","created":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T13:22:29Z","timestamp":1533820949000},"page":"260-268","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":63,"title":["Practice guideline update summary: Efficacy and tolerability of the new antiepileptic drugs I: Treatment of new-onset epilepsy"],"prefix":"10.1177","volume":"18","author":[{"given":"Andres M.","family":"Kanner","sequence":"first","affiliation":[{"name":"Miller School of Medicine, University of Miami, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Ashman","sequence":"additional","affiliation":[{"name":"Bronson Neuroscience Center, Bronson Methodist Hospital, Kalamazoo, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Gloss","sequence":"additional","affiliation":[{"name":"Department of Neurology, Charleston Area Medical Center, Charleston, WV"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Harden","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mount Sinai Beth Israel, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blaise","family":"Bourgeois","sequence":"additional","affiliation":[{"name":"Children's Hospital, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyn F.","family":"Bautista","sequence":"additional","affiliation":[{"name":"Epilepsy Center, Cleveland Clinic Foundation, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassel","family":"Abou-Khalil","sequence":"additional","affiliation":[{"name":"Department of Neurology, Vanderbilt University, Nashville, TN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evren","family":"Burakgazi-Dalkilic","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cooper Medical School, Rowan University, Cherry Hill, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esmeralda Llanas","family":"Park","sequence":"additional","affiliation":[{"name":"AMITA Health Medical Group, Hoffman Estates, IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Stern","sequence":"additional","affiliation":[{"name":"School of Medicine, University of California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Hirtz","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Vermont, Burlington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Nespeca","sequence":"additional","affiliation":[{"name":"Children's Hospital, University of California San Diego School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry","family":"Gidal","sequence":"additional","affiliation":[{"name":"School of Pharmacy, University of Wisconsin, Madison"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Faught","sequence":"additional","affiliation":[{"name":"School of Medicine, Emory University, Atlanta, GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"French","sequence":"additional","affiliation":[{"name":"Department of Neurology, New York University Langone Comprehensive Epilepsy Center, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,7,1]]},"reference":[{"key":"bibr1-1535-7597.18.4.260","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000123693.82339.FC"},{"key":"bibr2-1535-7597.18.4.260","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000123695.22623.32"},{"key":"bibr3-1535-7597.18.4.260","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.8.1540"},{"key":"bibr4-1535-7597.18.4.260","unstructured":"KannerAM, AshmanE, GlossD, et al.; on behalf of the American Academy of Neurology and American Epilepsy Society. 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