Introduction and objective:
Drug-resistant epilepsy (DRE) is a serious therapeutic challenge, as approximately 30% of epileptic patients do not achieve sustained seizure control despite using at least two appropriately selected antiepileptic drugs. Although pharmacotherapy is the basis of treatment, some patients need new solutions. The aim of this study is to present current therapeutic options for DRE, as well as promising drugs being tested in clinical trials.

Review methods:
The review article was compiled mainly on the basis of the PubMed database and the ClinicalTrials.gov website. Most of the articles included were published between 2018–2025.

Brief description of the state of knowledge:
In recent years, new therapeutic approaches have been investigated. Among a variety of treatment strategies studied, add-on therapy, dietary approaches including ketogenic diet (KD) and continuously improved neurostimulation techniques (DBS, VNS, RNS) are interventions of high clinical significance. Add-on therapy involves introducing additional drugs to the treatment regimen in order to reduce the number and severity of seizures, improve quality of life, prolong seizure-free periods and increase safety. Moreover, numerous international clinical trials on drugs and other treatments for DRE are being conducted, the results of which in the near future may possibly become available to a wider group of patients.

Summary:
Due to drug resistance in the treatment of epilepsy, there is a constant need to search for new, complex therapeutic methods that ensure better control of the disease.