Antiepileptic drug monitoring

Abstract

Antiepileptic drug (AED) monitoring has become part of the routine management of patients with seizures. It has increased the efficacy and safety of medical management. AED monitoring is helpful in assessing compliance, in preventing toxic side effects and in individualizing therapy. The technique of choice for measuring AED levels is gas-liquid chromatography. This offers a high degree of accuracy and specificity for the determination of the more commonly used antiepileptic drugs. The interpretation of AED plasma levels should be based on an understanding of total versus free drug plasma levels, therapeutic range, drug half-life, and time to reach steady state levels. When antiepileptic drugs are used in combinations interactions are to be anticipated to prevent adverse effects.