Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

283 questions · 285 findings · 33 reviews · Epilepsy

No studies found 31 · 10.9%GRADE not reported 13 · 4.6%Very low 33 · 11.6%Low 80 · 28.1%Moderate 96 · 33.7%High 32 · 11.2%

Topiramate vs placebo

50% or greater reduction in seizure frequency · people with drug‐resistant focal epilepsy

Topiramate leads to higher 50% or greater reduction in seizure frequency (ITT analysis) compared with placebo (high certainty).

1 finding from 1 review

Topiramate vs placebo

Adverse effects ‐ difficulty with concentration/concentration impaired/concentration‐attention difficulties · people with drug‐resistant focal epilepsy

Topiramate probably leads to higher adverse effects ‐ difficulty with concentration/concentration… compared with placebo (moderate certainty).

1 finding from 1 review

Carbamazepine vs phenytoin

Time to treatment failure (any reason related to treatment) All participants Range of · adults and children with newly onset partial or generalised epilepsy

Carbamazepine showed no clear difference in time to treatment failure (any reason related to treatment)All… compared with phenytoin (time to treatment failure) (moderate certainty).

1 finding from 1 review