[Antiepileptic drugs - fast versus slow titration and discontinuation].

The indication and management of an appropriate therapy with antiepileptic drugs (AEDs) requires an individualized diagnostic evaluation considering the clinical situation. Based on the current scientific data the therapeutic options and special aspects of the available AEDs are discussed with emphasis on the possibility of rapid initiation (therapeutic loading doses on day 1) or need of slow uptitration over several days or weeks in the context of different clinical situations. A sudden discontinuation or withdrawal of AEDs is only justified due to life-threatening side effects or for diagnostic purposes in the context of a presurgical workup. The debate on the appropriate time for a slow AED discontinuation (over a few weeks or several months) is still ongoing.