OBJECTIVES: To assess the AntiEpileptic Drugs (AED) usage and the prevalence of AED users in Campania, a region of approximately  5.8 million inhabitants in the south of Italy during the years 2005-2006. METHODS: We collected, from an electronic research database, all prescriptions for  AEDs  reimbursed in the years 2005-2006  in 8 local-health-authorities (70% of the overall population) of Campania. We calculated the number of subjects receiving more than a single AED prescription, to estimate the annual prevalence of AED users. Therefore we excluded users of morphine-like analgesic (ATC-code N02A). Annual prevalence of AED use was assessed in the entire sample, stratified by drug type and age group. RESULTS: We identified 107,959 subjects. The estimated crude 1-year prevalence of AED use increased  from 16.6/1000  (53.0 % female) in 2005 to 19.5/1000 (54.4%  female)  in 2006. Prevalence increased with age for both genders. Prevalence of AED use increased  from 5.9/1000 in 2005 to 8.7/1000 in 2006 for ‘new’ AEDs while was stable for ‘old’ AEDs (8.4/1000 in 2005, 8.2/1000 in 2006), excluding association between old-new and switchers.  The most frequent regimens were all monotherapy: phenobarbital, gabapentin, valproic acid, carbamazepina, lamotrigina were the most common AED in monotherapy  in 2005, pregabalin became first in 2006 when gabapentin went off-patent. CONCLUSIONS: The results of the study indicate an increasing prevalence of AED use with special reference to ‘newer’ compounds. The increase is mainly due to pregabalin, marketed in the end of 2004 with indications for epilepsy and neuropathic pain. Excluding pregabalin and gabapentin, commonly used for the treatment of neuropathic pain, older AEDs are the most frequent regimens. Probably older AEDs remain the first line treatment for epileptic disorders. This claim is in accordance with a previous study conducted in Italy from a General-Practitioners database (Savica et al., European Journal of Neurology, 2007)