With the recent entry of cenobamate into the Canadian market, through approval of cenobamate by Health Canada, ¹ and the subsequent important recommendation put forward by the Canadian Agency for Drugs and Technologies and Health (CADTH) that it should be reimbursed by public drug plans as adjunctive therapy in focal drug-resistant epilepsy in adults, ² it is an exciting time in the management of drug-resistant epilepsy. Not often do we have a medication available to us that provides a glimmer of hope for our patients who have trialed and failed numerous medications and non-pharmacological therapies. At the same time, it behooves us to critically understand the efficacy and adverse effects, and to determine where in our armamentarium new therapies lie. It can be particularly challenging in the pediatric space, where most medications are not approved for children, and one must usually extrapolate adult data until there is more pediatric evidence to examine. Freibauer et al ^{Reference Freibauer3} add a timely study looking at their tertiary care population of drug-resistant epilepsy to provide a snapshot of their initial experience with cenobamate. Having described a population that is very comparable to those at other Canadian academic centers, it is helpful to see how their experience compares to our anecdotal, day-to-day use. It is of course validating to see similar rates of efficacy in reducing seizure frequency. ^{Reference Lauxmann, Heuer and Heckelmann4} Studies like these are especially helpful if a particular institution’s practice in relation to aspects such as concomitant drug interactions is described (i.e., proactive reduction of high-dose clobazam in this case). Also interesting is to see their described experience with off-label indications (Lennox-Gastaut Syndrome, combined generalized and focal epilepsy) to see how this medication may apply to those populations, and also who has been excluded (i.e., primary generalized epilepsy). It is hopeful that the publication of this and similar studies will pave the way for increased awareness and usage of what has been demonstrated to be a safe and effective anti-seizure medication that will be able to significantly benefit our patients with drug-refractory epilepsy. In future studies, quality of life measures for both the patient and families will be important to demonstrate a more nuanced understanding of the impact of these new therapies.