A Cochrane review [Abstract] 1 included 14 studies with a total of 1116 subjects. Nine different pharmacological agents were compared: lamotrigine, carbamazepine, gabapentin, topiramate, felbamate, clobazam, cinromide, flunarizine and rufinamide. In the majority of trials, antiepileptic drugs provided moderate reduction in seizure frequency in that there was a significantly higher rate of responders (reduction of 50% or more) and occasional seizure freedom in people with intellectual disability. In general, antiepileptic drugs proven effective in the general epilepsy population appear to be effective in refractory epilepsy in people with intellectual disability. It is not possible to comment on relative efficacy between medications.
Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment) and inconsistency (heterogeneity in patients, interventions and outcomes).
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