Felbamate hydrate is primarily used in the treatment of epilepsy, particularly for patients who have not responded well to other antiepileptic medications. It is effective in managing partial seizures, with or without generalization, and is also used in Lennox-Gastaut syndrome, a severe form of childhood epilepsy. Due to its potential for serious side effects, such as aplastic anemia and liver toxicity, it is typically reserved for cases where the benefits outweigh the risks and is administered under strict medical supervision. Regular monitoring of blood counts and liver function is essential during treatment.