Prescribing Safety Assessment (PSA) Practice Exam

What is the first-line choice of antiepileptic drug for men experiencing a tonic seizure?

1. Carbamazepine

2. Lamotrigine

3. Valproate

4. Ethosuximide

The correct answer is: Valproate

Valproate is typically considered a first-line choice of antiepileptic medication for treating seizures, including tonic seizures. It offers broad-spectrum efficacy, meaning it can be effective against various seizure types, including generalized and focal seizures, and is particularly useful for patients who may present with both types. Additionally, valproate is often preferred due to its favorable side effect profile and well-established efficacy in managing seizure disorders. For men specifically, valproate can also be more appropriate because of the potential reproductive side effects associated with other antiepileptic medications, which may have implications for men. The other medications listed have specific uses and can be effective in certain contexts; however, they might not be considered as broad-spectrum or suitable for initial treatment in cases of tonic seizures. For example, carbamazepine is more often used for focal seizures and may not be as effective for tonic-clonic seizures. Lamotrigine has a good efficacy profile for various seizure types but is less established as a first-line option specifically for tonic seizures. Ethosuximide is primarily used for absence seizures and would not be appropriate for tonic seizures. Thus, valproate is the preferred initial choice in this context due to its broader indication and efficacy