Author Affiliations: Department of Neurology, Royal Melbourne Hospital and Department of Medicine, University of Melbourne, Victoria, Australia.
We thank Sethi for his interest in our article reporting the results of the KONQUEST (Keppra vs Older AEDs evaluating Neuropsychiatric, Neurocognitive and QUality of life outcomes in treatment of Epilepsy as Substitution monoTherapy) study.1 We acknowledge that drug absorption may vary between brand name antiepileptic drugs (AEDs) and their generic counterparts. In the KONQUEST study, all patients were randomized to treatment with brand name AEDs (ie, Keppra [levetiracetam], Tegretol CR [controlled-release carbamazepine], or Epilim [enteric-coated valproate]), so this should not have been a factor influencing the results of this study. We agree that the study findings raise doubts about whether newer AEDs, which are more expensive, result in overall better outcomes for patients than older generation AEDs.
O’Brien TJ, Hakami T, Todaro M. Older vs Newer Antiepileptic Drugs: Is Old Still Gold?—Reply. JAMA Neurol. 2013;70(5):656-657. doi:10.1001/jamaneurol.2013.214