Prescribing Safety Assessment (PSA) Practice Exam

Which antiepileptic drug is recommended as a first-line treatment for general focal seizures?

1. Sodium Valproate

2. Ethosuximide

3. Carbamazepine or Lamotrigine

4. Levetiracetam

The correct answer is: Carbamazepine or Lamotrigine

Carbamazepine and Lamotrigine are considered first-line treatments for focal seizures due to their efficacy and favorable side effect profiles. Both medications have established themselves as effective options through numerous clinical trials and real-world data, showing significant improvements in seizure control for patients with focal seizures. Carbamazepine works primarily by stabilizing hyperexcitable neuronal membranes and can reduce the frequency of seizures effectively. Lamotrigine, on the other hand, not only inhibits voltage-sensitive sodium channels but also has a broad spectrum of activity against various seizure types, making it a versatile choice in epilepsy management. While Sodium Valproate is a valuable option, particularly for generalized seizures and has broad-spectrum efficacy, it is not exclusively a first-line treatment specifically for focal seizures, thus limiting its ranking in this context. Ethosuximide is primarily used for absence seizures and does not have the efficacy indicated for focal seizures. Levetiracetam is also effective for a wide range of seizure types and can be used for focal seizures but is not typically listed as the primary choice over Carbamazepine or Lamotrigine, particularly in new-onset focal epilepsy. Therefore, the selection of Carbamazepine or Lamotrigine reflects current guidelines and evidence