[12.28.2022] Updated content, AnKing Overhaul for Step 1 & 2/AnKingMed, ID 98778

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Andy is going to weigh in

Yes, this is correct. I would agree to remove phenytoin as shown in FA2022. There’s still some debate institutionally and internationally about what is exactly first line and alternatives, but at least in the Cochrane review linked below, they determined valproate as the first‐line treatment for individuals with generalized tonic‐clonic seizures. Phenytoin was included in the analysis and compared. From the conclusion section: “carbamazepine and lamotrigine are suitable first‐line treatments for individuals with partial onset seizures and also demonstrates that levetiracetam may be a suitable alternative. High‐quality evidence from this review also supports the use of sodium valproate as the first‐line treatment for individuals with generalised tonic‐clonic seizures (with or without other generalised seizure types) and also demonstrates that lamotrigine and levetiracetam would be suitable alternatives to either of these first‐line treatments.” https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011412.pub2/full