A 65 year old male presented to a hospital with focal seizures. His renal function was normal. Which of the following is the drug of choice for this patient?
High-Yield Explanation
Carbamazepine and oxcarbazepine (related drug), phenytoin, lamotrigine and topiramate are currently the drug of choice approved for the initial treatment of partial seizures, including those that secondarily generalize.Overall they have very similar efficacy, but differences in pharmacokinetics and toxicity are the main determinants for use in a given patient.
Oxcarbazepine has the advantage of being metabolized in a way that avoids an intermediate metabolite associated with some of the side effects of carbamazepine. Oxcarbazepine also has fewer drug interactions than carbamazepine.