Generalized epilepsies are a large group of epilepsies with different clinical aspects and prognosis. Many antiepileptic drugs are available for the treatment of these seizures. This paper reviews the evidence relating to the treatment of this group of epilepsies. Historically, the great majority of patients have been treated with “old” anticonvulsant drugs. Over recent years, there has been a marked improvement in the pharmacological armamentarium of physicians. Today, “new” antiepileptic drugs, such as lamotrigine, levetiracetam, topiramate and zonisamide are useful tools in the treatment of pharmacoresistant epilepsies.