Due to the high prevalence of epilepsy in the world, patients with this pathology need more and more attention from neurologists, epileptologists, psychiatrists and family physicians. The aim of the work is to acquaint physicians who care for such patients with the main provisions of the modern scientific literature, author’s own experience in prescribing the first antiepileptic drug in the established diagnosis of epilepsy. The algorithm of the physician’s actions in the course of consultation of the patient is presented, the basic questions to which it is necessary to pay special attention are underlined; how to establish the diagnosis correctly, to appoint diagnostic procedures, to choose antiepileptic drug depending on the type of a seizure and etiology of epilepsy. The basic principles of drug administration in structural (post-stroke, post-traumatic, mesial temporal), genetic, cryptogenic and undifferentiated epilepsy are given. Third-generation drugs, having similar efficacy with classic, traditional second-generation drugs, show advantages in less teratogenicity, better tolerability, less interaction with other drugs prescribed to patients with comorbid pathology. Each patient needs a holistic assessment of their condition and an individualized approach to prescribing treatment.
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