Oldest best in childhood absence epilepsy

A landmark comparison of three drugs widely used to treat childhood epilepsy has found the oldest is the most effective. The study of almost 500 children found that ethosuximide, available since the 1950s, was the most effective at controlling childhood absence epilepsy with the fewest side effects. Valproate came second, and the newest drug, lamotrigine, was third, according to the research published in the New England Journal of Medicine. The study involved children aged 2.5 to 13 years with newly diagnosed epilepsy. They were randomly assigned to one of the three drugs. The study evaluated whether they were free of seizures without intolerable side effects after 16 weeks and also measured how the drugs affected the children's ability to pay attention. After 4 months of treatment ethosuximide prevented seizures in 53% of the children, 58% of the children taking valproate and 29% taking lamotrigine. However, only 33% of those taking the older drug had significant attention problems, compared to 49% of those taking valproate, the researchers found. There were no significant differences between the three groups with regard to discontinuation of treatment due to side effects. However, the authors noted that given the increased risk of generalised tonic-clonic seizures as children grow older, and given ethosuxamide’s reported lack of effectiveness in preventing such seizures, long-term follow up of the study cohort was needed....