IMPORTANCEA study published in 2000 showed that more than one-third of adults with epilepsy have inadequate control of seizures with antiepileptic drugs (AEDs). This study evaluates overall treatment outcomes in light of the introduction of more than 1 dozen new AEDs in the past 2 decades. OBJECTIVE To assess long-term treatment outcome in patients with newly diagnosed and treated epilepsy. DESIGN, SETTING, AND PARTICIPANTSThis longitudinal observational cohort study was conducted at the Epilepsy Unit of the Western Infirmary in Glasgow, Scotland. A total of 1795 individuals who were newly treated for epilepsy with AEDs between July 1, 1982, and October 31, 2012, were included in this analysis. All patients were followed up for a minimum of 2 years (until October 31, 2014) or until death, whichever came sooner. Data analysis was completed between March 2015 and May 2016.EXPOSURES Treatment with antiepileptic drugs for patients newly diagnosed with epilepsy.MAIN OUTCOMES AND MEASURES Seizure control was assessed at the end of the study period. Probability of achieving 1-year seizure freedom was estimated for each AED regimen prescribed. Multivariable models assessed the associations between risk factors and AED treatment outcome after adjustments were made for demographic and clinical characteristics.

The screening policy was associated with prevention of carbamazepine-induced SJS/TEN without reducing the overall burden of AED-induced SJS/TEN, likely because of clinicians preferring AEDs that do not require genetic screening but may also induce SJS/TEN.