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New anticonvulsants in everyday clinical use Abstract. In summary, the armamentarium of the clinically active epileptologist is constantly expanding. The newer substances often show a better tolerability and a lower interaction potential than the older substances, but they are not more effective. The selection of the anticonvulsant depends on the individual situation and takes into account the type of epilepsy, age, comorbidities and, in the case of women, any desire to have children. Because epilepsies are often still refractory to therapy, new substances are urgently needed and several promising preparations are currently under development. Epilepsy surgery is also making great progress, so it is recommended that, after the unsuccessful use of two adequate anticonvulsants, this often very successful option be considered, which ideally leads to a cure from epilepsy, and that patients be referred to an appropriate centre.