John Paul Leach, MD, MBBS, University of Glasgow, Glasgow, UK, talks on the progress that has been made in the treatment of epilepsy and the important unmet needs that remain. While the last 20 years has seen extensive growth in the availability of epilepsy treatments with improved usability and tolerability, there has been little improvement in the incidence of seizure freedom. Drug resistance remains an issue and further drug development is warranted. Prof. Leach comments on what can be done to improve outcomes for patients that do not respond well to treatment early on. Open patient discussions are important to ensure the optimal management approach has been chosen. This interview took place during the European Academy of Neurology 2021 congress.