ReviewDrugs2006
Combination therapy in epilepsy: when and what to use.
Review in Drugs, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 1 synthesis or guideline pooled it, 180 citations in OpenAlex.
- Medical Technology: A Systematic Review on Medical Devices Utilized for Epilepsy Prediction and Management.Current neuropharmacology · 2022Pooled it
- Real-world data on eslicarbazepine acetate as add-on to antiepileptic monotherapy.Acta neurologica Scandinavica · 2016Trial
- Efficacy of topiramate in adult patients with symptomatic epilepsy: an open-label, long-term, retrospective observation.CNS drugs · 2009Trial
- Long-Term Follow-Up of Levetiracetam Monotherapy Versus Add-On Therapy in Pediatric Epilepsy.Children (Basel, Switzerland) · 2026Article
- Anticonvulsant Effects of Citronellal, Daidzin, and Phytol, Possibly Through GABABrain and behavior · 2026Article
- BETMB: A Dual-Target Compound for Synergistic Suppression of Neuronal Hyperexcitability in Refractory Epilepsy via Concurrent Modulation of Nav Channels and GABACNS neuroscience & therapeutics · 2026Article
- Prediction of personalized antiseizure medications response based on clinical signatures in epilepsy.Scientific reports · 2025Article
- Predicting Seizure Risk from Routine Electroencephalographs in Medical Intensive Care Units Using the 2HELPS2B Score.Life (Basel, Switzerland) · 2025Article
- Antiepileptic Drug Combinations for Epilepsy: Mechanisms, Clinical Strategies, and Future Prospects.International journal of molecular sciences · 2025Review
- (+)-Borneol Enhances the Antiseizure Effects of Retigabine by both Pharmacokinetic and Pharmacodynamic Interaction.Neurochemical research · 2025Article
- The association of polytherapy and psychiatric comorbidity in epilepsy.Epilepsy & behavior : E&B · 2025Article
- ILF-neurofeedback in clinical practice: examining symptom change and performance metrics across diagnostic groups.Frontiers in human neuroscience · 2025Article
- A Cross-Sectional Study Comparing Oxidative Stress in Patients with Epilepsy Treated with Old and New Generation Antiseizure Medications.Medicina (Kaunas, Lithuania) · 2024Article
- A quality of care assessment for women of childbearing potential with epilepsy in Bhutan: An observational study.Epilepsy & behavior : E&B · 2024Observational
- Antiseizure adverse drug reaction and associated factors among epileptic patients at Jimma Medical Center: a prospective observational study.Scientific reports · 2024Observational
- The Concurrent Use of Phenytoin and Levetiracetam for Seizure Prophylaxis in ICU Patients: The "Arrowhead Rationale".Cureus · 2023Review
- Therapeutic efficacy of voltage-gated sodium channel inhibitors in epilepsy.Acta epileptologica · 2023Review
- Enhanced Sestrin expression through Tanshinone 2A treatment improves PI3K-dependent inhibition of glioma growth.Cell death discovery · 2023Article
- Review
- Optimizing treatment persistence in epilepsy: a comparative analysis of combined antiseizure medications with different mechanisms of action.Therapeutic advances in neurological disorders · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
After being regarded as a last resort for over two decades, the role of combination therapy as a treatment strategy for epilepsy is undergoing re-evaluation. This is a result of the growing appreciation that all seizures cannot be controlled by monotherapy in a substantial proportion of patients, and of the development of a range of modern antiepileptic drugs (AEDs), some of which are better tolerated and less prone to complex pharmacokinetic drug interactions than their older counterparts.Robust evidence to guide clinicians on when and how to combine AEDs is lacking, and current practice recommendations are largely empirical. Monotherapy should remain the treatment of choice for newly diagnosed epilepsy. A combination of two AEDs can be considered after failure, resulting from lack of efficacy, of one or two different monotherapy regimens. A few patients will become seizure-free with a combination of three AEDs, but treatment with a combination of four or more is unlikely to be successful. There is some evidence to support a pharmacomechanistic approach to AED combination. Care should be taken to avoid excessive drug load, which is associated with increased toxicity. Bigger and better randomised, controlled studies are needed to determine the optimal time and way to combine AEDs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.