PURPOSE OF REVIEW: There is a need for newer anti-epileptic drugs (AEDs) with 
improved efficacy and tolerability. This article reviews AEDs introduced since 
2007 and investigational compounds in clinical development.
RECENT FINDINGS: Two recently introduced AEDs, stiripentol and rufinamide, have 
been licensed exclusively for orphan indications, that is severe myoclonic 
epilepsy of infancy (stiripentol, Europe) and Lennox-Gastaut syndrome 
(rufinamide, Europe and the USA). This signals a welcome new trend to explore 
novel treatments in specific pediatric syndromes for which there are high 
therapeutic needs. Two additional AEDs, lacosamide and eslicarbazepine acetate, 
have been licensed recently for a more traditional indication, refractory 
partial-onset seizures. Although newly introduced agents given as adjunctive 
therapy have been found to be superior to placebo in reducing seizure frequency, 
the ultimate goal of sustained seizure freedom is rarely achieved. Therefore, 
the search for better agents should continue. Several investigational compounds 
are currently in various stages of clinical development.
SUMMARY: The recent introduction of newer AEDs has enlarged the armamentarium 
against epilepsy. However, newer agents had only a modest impact on the 
probability of achieving long-term remission. Novel strategies for the discovery 
and development of truly innovative AEDs are sorely needed.