The past 20 years have seen the development and licensing of more than 10 drugs for refractory epilepsy. ▼Lacosamide (Vimpat) is the most recent example and more are likely to be available soon. However, the current model for assessing new treatments for refractory epilepsy is increasingly questionable.

Potential antiepileptic drugs are tested in trials in which patients with drug-refractory focal epilepsy are randomised to either a new drug or placebo, …