The commonest antiepileptics and their indications

1. Big picture

For the exam, antiepileptic drug choice is mainly based on seizure type / epilepsy syndrome, not simply on the EEG. The key practical rule is:

Focal epilepsy → carbamazepine / lamotrigine / levetiracetam-type drugs. Generalized epilepsy → valproate-type broad-spectrum drugs, but avoid valproate when pregnancy is possible if alternatives work. Absence epilepsy → ethosuximide if pure absence. Myoclonic epilepsy / juvenile myoclonic epilepsy → valproate is classically most effective; levetiracetam is an important alternative. West syndrome → ACTH/steroids and vigabatrin.

Modern guidelines increasingly prefer **lamotrigine or levetiracetam as first-li