**2. Medical treatment**

There is a large number of anticonvulsants for drug therapy of epilepsy, although those of more recent and of latest generations are not inferior to those of the older generation in their anticonvulsant effects. Therefore, a choice must be made on the basis of possible interference and interaction profiles and taking into account the individual situation of each patient.

Special attention in the treatment decision requires certain patient groups such as women of childbearing age because certain anticonvulsants have increased teratogenicity. For example, Valproic acid should be avoided due to an increased risk of malformation and an unfavorable effect on the later intellectual development of the unborn child, especially in higher doses during pregnancy. However, other patient groups also need specific consideration: Patients with intellectual disabilities may experience an increase in their existing limitations due to paradoxical disturbances or drug-related negative effects on cognitive performance. Older patients are particularly susceptible to drug interferences due to various co−/multi-morbidities, various concomitant medications and the resulting interactions that may not always be foreseeable, as well as pharmacodynamics that change due to age.
