Epilepsy, a globally pervasive chronic central nervous system disorder, is characterized by an imbalance between neuronal excitation and inhibition, primarily involving the interplay of glutamate and GABA systems. This comprehensive review delineates the cutting-edge research developments in the field of epilepsy treatment, spanning an extensive spectrum from molecular pathophysiological mechanisms to clinical therapeutic strategies, with a foresight into future research trajectories. The review meticulously examines the pivotal roles of AMPA and NMDA receptors in the genesis of epileptic seizures, as well as the implications of GABA receptor dysfunction on disease progression. Regarding therapeutic strategies, the article juxtaposes the mechanisms of action of conventional and newer antiepileptic drugs, placing special emphasis on the significance of non-pharmacological interventions, such as the ketogenic diet and lifestyle modifications, in the comprehensive management of epilepsy. Furthermore, the review explores the potential of personalized medicine and the integration of Western and traditional Chinese medicine, aiming to offer more precise and effective treatment options for patients with epilepsy. By providing an in-depth analysis of existing treatment modalities and prognosticating future.