Mental health

Antiepileptic drug treatment after first unprovoked seizure

Question 8: Should antiepileptic drug treatment be started after first unprovoked seizure in non-specialist health settings?

Management of epilepsy

  • Population: adults and children with a first unprovoked seizure
  • Interventions: antiepileptic drug treatment offered after first seizure
  • Comparison:
    • antiepileptic drug treatment offered only after a seizure recurrence
    • placebo
  • Outcomes:
    • time to first seizure
    • time to 2-year remission
    • adverse effects
    • quality of life.


Antiepileptic drugs should not be routinely prescribed to adults and children after a first unprovoked seizure. In adults and children with a high risk of recurrence (e.g. presence of neurological deficit, associated handicaps), referral should be made to specialist setting for further assessment.
Strength of recommendation: STRONG

Evidence profile