ReviewDrugs & aging2026
Antiseizure Medications in Older Adults with Epilepsy: Considerations in Pharmacology, Safety, Tolerability, and Effectiveness of Newer Agents.
Review in Drugs & aging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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
1 citing paper in PubMed.
- The Saga of Late-Onset Unexplained Epilepsy.Epilepsy currents · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Older adults represent one of the fastest-growing populations living with epilepsy, yet they remain underrepresented in clinical trials. In this age group, antiseizure medication selection is frequently complicated by multimorbidity, polypharmacy, age-related changes in renal and hepatic function, and vulnerability to adverse effects such as falls and cognitive impairment. Because many antiseizure medications demonstrate comparable efficacy for seizure control, medication tolerability and quality-of-life considerations often play a decisive role in treatment selection for older adults. This narrative review synthesizes available evidence on the tolerability of commonly used antiseizure medications in adults aged 65 years and older, with a focus on adverse-effect profiles, treatment retention, and clinical considerations unique to aging populations. Data from previous trials are reviewed for established agents (including levetiracetam, lamotrigine, carbamazepine, gabapentin, and pregabalin) as well as newer antiseizure medications such as lacosamide, brivaracetam, cenobamate, eslicarbazepine acetate, and perampanel. Emerging evidence suggests that newer agents demonstrate favorable efficacy and tolerability at lower doses in older adults, though falls, dizziness, and neuropsychiatric effects can be dose limiting. Newer intranasal benzodiazepine rescue therapies offer practical advantages for seizure clusters, but data specific to older adults remain limited. The review also addresses tolerability considerations related to renal and hepatic impairment, osteoporosis, anticoagulation, chemotherapy, and special populations including individuals with dementia, post-stroke epilepsy, tumor-related epilepsy, and depression. Overall, existing evidence supports the use of lower starting doses, slower titration schedules, and avoidance of enzyme-inducing antiseizure medications when possible in older adults. The heterogeneity of this population highlights the need for future studies stratified by frailty, cognitive status, and the living environment to better inform individualized tolerability-focused epilepsy care in later life.
Indexed as
Identifiers
41706289What Socratic 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 Socratic graph.