What do systematic reviews say?

Stiripentol vs add‐on placebo

Add‐on stiripentol showed no clear difference in seizure freedom compared with add‐on placebo (low certainty).

• Stiripentol add‐on therapy for drug‐resistant focal epilepsy 2022 · Cochrane Headline outcomes only
  RR 1.18 [0.31, 4.43]
  1 study · 32 participants
  Low

Brivaracetam vs placebo

Brivaracetam may leads to higher seizure freedom compared with placebo (low certainty).

• Brivaracetam add‐on therapy for drug‐resistant epilepsy 2022 · Cochrane Headline outcomes only
  RR 5.89 [2.3, 15.13]
  6 studies · 2411 participants
  Low

Any dose of lacosamide vs placebo

Any dose of lacosamide may leads to higher seizure freedom compared with placebo (low certainty).

• Lacosamide add‐on therapy for focal epilepsy 2021 · Cochrane Headline outcomes only
  RR 2.27 [1.35, 3.83]
  5 studies · 2199 participants
  Low

Sulthiame vs phenytoin

• Sulthiame monotherapy for epilepsy 2021 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 146 participants
  GRADE not reported

Sulthiame vs placebo

• Sulthiame monotherapy for epilepsy 2021 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 100 participants
  GRADE not reported

Sulthiame vs levetiracetam

Sulthiame showed no clear difference in seizure freedom compared with levetiracetam (low certainty).

• Sulthiame monotherapy for epilepsy 2021 · Cochrane Headline outcomes only
  RR 1.12 [0.88, 1.44]
  1 study · 43 participants
  Low

Carisbamate vs placebo

It is very uncertain whether carisbamate changes seizure freedom compared with placebo (very low certainty).

• Carisbamate add‐on therapy for drug‐resistant focal epilepsy 2021 · Cochrane Headline outcomes only
  RR 2.43 [0.84, 7.03]
  1 study · 540 participants
  Very low

Rufinamide vs placebo

Rufinamide showed no clear difference in seizure freedom compared with placebo (moderate certainty).

• Rufinamide add‐on therapy for drug‐resistant epilepsy 2020 · Cochrane Headline outcomes only
  RR 1.32 [0.36, 4.86]
  1 study · 73 participants
  Moderate

Topiramate vs placebo

Topiramate probably leads to higher seizure freedom compared with placebo (moderate certainty).

• Topiramate add‐on therapy for drug‐resistant focal epilepsy 2019 · Cochrane Headline outcomes only
  RR 3.67 [1.79, 7.54]
  8 studies · 1177 participants
  Moderate

Clobazam vs placebo

• Clobazam add‐on therapy for drug‐resistant epilepsy 2019 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 175 participants
  Very low

Intervention not reported

The intervention probably leads to higher freedom from seizures (moderate certainty).

• Eslicarbazepine acetate add‐on therapy for drug‐resistant focal epilepsy 2021 · Cochrane Headline outcomes only
  RR 3.16 [1.73, 5.78]
  6 studies · 1922 participants
  Moderate

Clobazam vs phenytoin

The review found no eligible studies for this question.

• Clobazam monotherapy for focal or generalized seizures 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found
• Clobazam monotherapy for focal or generalized seizures 2018 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Clobazam vs carbamazepine

Clobazam showed no clear difference in seizure freedom at 4 weeks compared with carbamazepine (low certainty).

• Clobazam monotherapy for focal or generalized seizures 2018 · Cochrane Headline outcomes only
  RR 0.85 [0.55, 1.32]
  1 study · 43 participants
  Low
• Clobazam monotherapy for focal or generalized seizures 2018 · Cochrane Headline outcomes only
  RR 0.95 [0.66, 1.36]
  1 study · 43 participants
  Low

Add‐on lamotrigine vs placebo

It is very uncertain whether add‐on lamotrigine changes seizure freedom (i.e. total cessation of seizure activity) compared with placebo (very low certainty).

• Lamotrigine add‐on therapy for drug‐resistant generalised tonic‐clonic seizures 2020 · Cochrane Headline outcomes only
  RR 1.55 [0.89, 2.72]
  2 studies · 270 participants
  Very low