Truly "rational" polytherapy: Maximizing efficacy and minimizing drug interactions, drug load, and adverse effects

Research output: Contribution to journalReview article

60 Scopus citations


While several newer AEDs have study data that support monotherapy usage, most possess FDA indications for adjunctive treatment of partial onset seizures, leading to their initial (and often persistent) clinical use as adjunctive polytherapy for patients with refractory epilepsy. This review considers a practical approach to the appropriate role for polytherapy in epilepsy, presents, the evidence for AED polytherapy, reviews the mythic but practically reasonable concept of "rational polytherapy," and concludes with practical strategies for avoiding and employing polytherapy in clinical pratice. The appropriate indications for AED polytherapy include transtional polytherapy during titration of a new adjunctive AED toward monotherapy or long-term maintenance AED polytherapy in medically refratory epilepsy.

Original languageEnglish (US)
Pages (from-to)96-105
Number of pages10
JournalCurrent Neuropharmacology
Issue number2
StatePublished - Oct 12 2009



  • Antiepileptic drugs
  • Drug interactions
  • Drug load
  • Epilepsy
  • Polytherapy

ASJC Scopus subject areas

  • Pharmacology
  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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