What do systematic reviews say?

VGB vs CBZ monotherapy

VGB showed no clear difference in time to treatment withdrawal compared with CBZ monotherapy (low certainty).

• Vigabatrin versus carbamazepine monotherapy for epilepsy 2015 · Cochrane Headline outcomes only
  HR 0.75 [0.52, 1.1]
  1 study · 446 participants
  Low

Lamotrigine vs placebo

Summary of findings: lamotrigine showed no clear difference in treatment withdrawal compared with placebo (moderate certainty).

• Lamotrigine add‐on therapy for drug‐resistant focal epilepsy 2023 · Cochrane Headline outcomes only
  RR 1.11 [0.91, 1.37]
  14 studies · 1806 participants
  Moderate

Add‐on felbamate vs placebo

• Felbamate add‐on therapy for drug‐resistant focal epilepsy 2022 · Cochrane Headline outcomes only
  no estimate extracted
  4 studies · 236 participants
  Very low

Brivaracetam vs placebo

Brivaracetam showed no clear difference in treatment withdrawal compared with placebo (low certainty).

• Brivaracetam add‐on therapy for drug‐resistant epilepsy 2022 · Cochrane Headline outcomes only
  RR 1.27 [0.94, 1.74]
  6 studies · 2411 participants
  Low

Any dose of lacosamide vs placebo

Any dose of lacosamide probably leads to higher treatment withdrawal compared with placebo (moderate certainty).

• Lacosamide add‐on therapy for focal epilepsy 2021 · Cochrane Headline outcomes only
  RR 1.57 [1.24, 1.98]
  5 studies · 2199 participants
  Moderate

Sulthiame vs placebo

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

Sulthiame vs phenytoin

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

Sulthiame vs levetiracetam

Sulthiame showed no clear difference in treatment withdrawal compared with levetiracetam (low certainty).

• Sulthiame monotherapy for epilepsy 2021 · Cochrane Headline outcomes only
  RR 0.32 [0.1, 1.03]
  1 study · 43 participants
  Low

Add‐on lamotrigine vs placebo

It is very uncertain whether add‐on lamotrigine changes treatment withdrawal compared with placebo (very low certainty).

• Lamotrigine add‐on therapy for drug‐resistant generalised tonic‐clonic seizures 2020 · Cochrane Headline outcomes only
  RR 1.2 [0.72, 1.99]
  2 studies · 270 participants
  Very low

Rufinamide vs placebo

Rufinamide probably leads to higher treatment withdrawal compared with placebo (moderate certainty).

• Rufinamide add‐on therapy for drug‐resistant epilepsy 2020 · Cochrane Headline outcomes only
  RR 1.83 [1.45, 2.31]
  6 studies · 1759 participants
  Moderate

Topiramate vs placebo

Topiramate leads to higher treatment withdrawal compared with placebo (high certainty).

• Topiramate add‐on therapy for drug‐resistant focal epilepsy 2019 · Cochrane Headline outcomes only
  RR 2.37 [1.66, 3.37]
  12 studies · 1650 participants
  High

Tiagabine vs placebo control

Tiagabine probably leads to higher treatment withdrawal compared with placebo control (moderate certainty).

• Tiagabine add‐on therapy for drug‐resistant focal epilepsy 2019 · Cochrane Headline outcomes only
  RR 1.81 [1.25, 2.62]
  3 studies · 769 participants
  Moderate

Clobazam vs placebo

• Clobazam add‐on therapy for drug‐resistant epilepsy 2019 · Cochrane Headline outcomes only
  no estimate extracted
  4 studies · 197 participants
  Very low

Losigamone vs placebo

Losigamone probably leads to higher treatment withdrawal compared with placebo (moderate certainty).

• Losigamone add‐on therapy for focal epilepsy 2019 · Cochrane Headline outcomes only
  RR 2.16 [1.28, 3.67]
  2 studies · 467 participants
  Moderate

Sulthiame add‐on vs placebo

The review found no eligible studies for this question.

• Sulthiame add‐on therapy for epilepsy 2019 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Intervention not reported

The intervention showed no clear difference in treatment withdrawal (any reason) (moderate certainty).

• Eslicarbazepine acetate add‐on therapy for drug‐resistant focal epilepsy 2021 · Cochrane Headline outcomes only
  RR 1.25 [0.93, 1.7]
  7 studies · 2185 participants
  Moderate

Carisbamate vs placebo

It is very uncertain whether carisbamate changes treatment withdrawal for any reason compared with placebo (very low certainty).

• Carisbamate add‐on therapy for drug‐resistant focal epilepsy 2021 · Cochrane Headline outcomes only
  RR 1.32 [0.82, 2.12]
  4 studies · 2211 participants
  Very low

Intervention not reported

The intervention probably leads to higher treatment withdrawal (adverse effect) (moderate certainty).

• Eslicarbazepine acetate add‐on therapy for drug‐resistant focal epilepsy 2021 · Cochrane Headline outcomes only
  RR 2.72 [1.66, 4.46]
  7 studies · 2185 participants
  Moderate

Carisbamate vs placebo

It is very uncertain whether carisbamate changes treatment withdrawal due to adverse events compared with placebo (very low certainty).

• Carisbamate add‐on therapy for drug‐resistant focal epilepsy 2021 · Cochrane Headline outcomes only
  RR 1.8 [0.78, 4.17]
  4 studies · 2211 participants
  Very low

Clobazam vs placebo

• Clobazam add‐on therapy for drug‐resistant epilepsy 2019 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 150 participants
  Very low