Valproic acid (trade name Depakene) Valproic acid has a broad antiepileptic spectrum and inhibits liver enzymes, and is the drug of choice for the treatment of classic akathisia, myoclonic seizures and generalized tonic-clonic seizures, especially when these seizure types form part of an idiopathic generalized epilepsy syndrome. It is also used in patients with various partial-onset seizures secondary to generalized tonic-clonic seizures. Valproic acid is superior to other traditional antiepileptic drugs in the treatment of atonic epilepsy or juvenile myoclonic epilepsy. General adverse effects include weight gain, hair loss, tremor, and the most serious adverse effects are hepatotoxicity and teratogenicity. The incidence of polycystic ovary syndrome is higher than that of other traditional antiepileptic drugs. Recently, the use of sodium valproate extended-release form of Depakene is preferred to avoid peak and trough effects and to ensure smooth blood concentrations. It is administered orally to adults at an initial dose of 400 mg/d, increasing by 200 mg each time to a maintenance dose of 600-1800 mg/d, divided into 2 doses, i.e., every 12 hours. The extended-release dosage form can be taken once daily; children’s daily dose is 15-30mg/kg body weight. Carbamazepine (trade name Deloitte) Carbamazepine is the drug of choice for partial seizures and the first-line drug for tonic seizures, clonic seizures and secondary generalized tonic-clonic seizures, and is very effective for nocturnal frontal lobe epilepsy. It is ineffective and exacerbates myoclonic seizures, akathisia, atypical akathisia and atonic seizures. The most common adverse drug reactions are drowsiness, impaired balance, leukopenia, and rash. The ideal initial dose for adults is 100 mg per night, with a maintenance dose of 400-1200 mg/d, in increments or decrements of 100 mg; for children, 10-20 mg/(kg・d), divided into 3-4 doses, i.e., every 6-8 hours. Clonazepam (Clonidine) is mainly used for myoclonic seizures that are poorly treated with valproic acid or cannot tolerate valproic acid treatment. It is also used as a second-line drug for intractable akathisia, atonic seizures, and photosensitive epilepsy. The efficacy in tonic-clonic seizures is controversial. Given that clonazepam is characterized by sedation, motor retardation, memory impairment, and susceptibility to drug resistance and withdrawal seizures, long-term maintenance application is not recommended; dose reduction should also be slow, at a rate of 0.25-lmg per week. orally, with an initial adult dose of 0.5mg/d and a maintenance dose of 2-10mg/d.