Epilepsy is a common neurological condition and up to 3% of people will experience seizures at some time in their lives. Epilepsy is a complex condition with many different causes and seizures can take many different forms. Epilepsy can be treated with antiepileptic drugs and may have to be taken for life. The ultimate goal of treatment is to maximise quality of life by eliminating seizures at drug doses that do not cause side effects. However, for many patients there is a necessary trade-off between effective seizure control and side effects, which can diminish quality of life.

Over the past 20 years, a number of new drugs have become available for the treatment of epilepsy. These new drugs have been approved for NHS use on the basis of information from short term trials. These trials do not provide information about the longer term outcomes which inform decisions made by doctors and patients, nor do they provide any useful health economic data.

A clinical trial called SANAD-I began in 1999 and compared the effectiveness and cost effectiveness of standard and new treatments that were available at that time. SANAD-I identified lamotrigine (a new drug) as an effective and cost-effective first-line treatment for patients with a focal epilepsy, and confirmed that valproate (a standard treatment) should remain a first-line drug for patients with a generalised epilepsy or seizures that clinicians find difficult to classify. Since SANAD-I, a number of newer treatments have become available, the most promising of which are levetiracetam and zonisamide.

SANADII will compare the effectiveness and cost-effectiveness of the drugs named above and examine quality of life in patients with newly diagnosed epilepsy (trial protocol). 

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