Initial monotherapy of patients with epilepsy is the key to further therapeutic success

August 18, 2022
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The conditions for the success of the first monotherapy of epilepsy are primarily compliance antiepileptic drugs (AEDs) of the seizure type and form of epilepsy, in adult patients, the seizure type is the majority of cases is a determining indicator, but the form of epilepsy should also be taken into account. Undoubtedly, these parameters are closely related to each other, but for the clinician it is adequate the choice should take into account all the clinical features of the patient. The choice of AEDs should be made not only according to the type of attack and the form of epilepsy. It is also necessary to understand that appropriate first- and second-line drugs and what is especially important understand that there are drugs that should not be prescribed in certain clinical situations. At when prescribing the first monotherapy, preference should be given to new AEDs that have a much better range of safety and portability. A very important factor in the success of initial monotherapy is the appointment of AEDs in adequate doses. The problems of choosing the first monotherapy are extremely relevant in clinical practice. The effectiveness of adequate first monotherapy is about 45–60%. It is efficiency and the tolerability of the first monotherapy determines the patient’s compliance in the future. Patients first of all pay attention to the absence of side effects of treatment at the beginning of taking drugs. As they do not yet have a large effect experience of the negative impact of attacks on their quality of life, precisely adequate choices the first monotherapy helps to reduce the number of patients with secondary pharmacoresistance to АEDs and as a result — a decrease in the number of patients with disability.

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