[Controversies about the new anti-epileptic drugs]. / Controversias en torno a los nuevos fármacos antiepilépticos.

OBJECTIVE: The search for the ideal anti-epileptic drug (FAE) which is a drug to control all types of seizures, with no side-effects and a good pharmacokinetic profile, has been the incentive to carry out research into the development of the new FAE for the past ten years. As a result, a total of six new FAES have reached the market in Spain in the recent years: viagbatrin (VGB) lamotrigine (LTG), gabapentin (GBP), felbamate (FBM), tiagabine (TGB) and topiramate (TPM). DEVELOPMENT: The authors describe the available scientific evidence regarding efficacy, safety, tolerance, cost and effect on the quality of life of epileptic patients with these drugs. CONCLUSIONS: Inclusion of these new FAE has increased the therapeutic arsenal available for the treatment of epilepsy, a heterogeneous condition, and in general guaranteed comparable efficacy and better tolerance than the classical FAE. Besides, some of these FAE have shown selective actions in specific epileptic syndromes. However, the safety profile is still not completely clear, the direct cost is considerably higher than that of classical FAE and they have had only a modest effect on the long-term prognosis of epilepsy. Initial expectations of their use have still not been fulfilled.