Epilepsy has a great burden on patients and carries great difficulties in available treatment options. Epilepsy is not a simple disease to treat due to the large variance in types. Currently there are over 25 different anti-epileptics, which function in different, or overlapping ways. Anti-epileptics have been in the making for decades, and newer types are being produced. The newer types of antiepileptics are increasingly beneficial due to the decreased profile of side effects, and their severity of those side effects. The mechanism of these drugs is not fully known but they have been in use for the treatment of other disorders such as psychiatric disorders, or migraine prophylaxis. It is vital to understand the efficacy, and potential side effects of the old, and new anti-epileptics to be able to provide the best form of care with these drugs.