The diagnosis and management of patients with epilepsy is often undertaken by pediatricians, internists, and geriatricians (primary care physicians [PCPs]). Although referral to a neurologist may be necessary if the diagnosis of epilepsy is unclear or if the patient does not respond to initial therapy with antiepileptic drugs, PCPs may subsequently follow-up with patients to implement the recommendations of the neurologist. To maximize the likelihood of treatment success, PCPs should supplement antiepileptic drug therapy with patient education and referrals for psychosocial and vocational support when needed. Special considerations are warranted for women of childbearing potential and elderly patients.