The factors that relate to the drug choice are seizures and syndromes, psychiatric comorbidities, medical comorbidities, enzyme induction, potential for tertogenesis, older people and learning disability. For the first dose, choose a drug with a spectrum of activity and side-effects that has the potential to produce seizure freedom without long-term sequelae. Keep in mind the patient’s seizures and/or epilepsy syndrome, gender, age, weight, psychiatric and other comorbidities, etc. The efficacy and exacerbations should be considered as well. Valproate is a broad spectrum AED used for any seizure type.