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June 1996

Vigabatrin and Carbamazepine Monotherapy for Newly Diagnosed Epilepsy-Reply

Author Affiliations

Department of Neurology University Hospital of Kuopio POB 1777 70211 Kuopio, Finland
A. I. Virtanen-Institute University of Kuopio Kuopio, Finland

Arch Neurol. 1996;53(6):478. doi:10.1001/archneur.1996.00550060019006

In reply  We thank Walker et al1 for their comments regarding our article comparing vigabatrin and carbamazepine monotherapy in patients with newly diagnosed epilepsy.While we fully agree with them that the goal of the modern AED treatment should be freedom from seizures, the primary combined efficacy and safety end point of our clinical study was the drug success rate (ie, the proportion of patients continuing successful treatment with the randomly assigned drug) after 12 months of steady-state treatment. Successfully treated patients did not have intolerable side effects and were either seizure-free or had 1 generalized or 1 to 4 partial seizures during 12 months of follow-up. As we mention in the "Comment" section, the open-label design allowed us to approximate good clinical practice with each drug. In normal clinical practice, after starting therapy for a patient with newly diagnosed epilepsy, one does not rush to change the first

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