Clinical application of the monitoring of anticonvulsant drug levels.
The drug treatment of epilepsy poses considerable problems, including the high prevalence and early age of onset of seizures, the relatively poor prognosis in many patients, prolonged polypharmacy, chronic toxicity, and uncertainty of the relative efficacy of individual drugs. The application of recent knowledge of the clinical pharmacology of the major anticonvulsants offers a partial solution to several of these problems. Although there is no therapeutic range for any drug applicable to all patients, a more simple rational and effective approach to treatment is possible with the guidance of serum level monitoring. In new referrals, there is considerable potential for monotherapy, and the avoidance of polypharmacy and chronic toxicity. Reduction in polypharmacy in chronic patients is more difficult, but in many can be achieved with reduction in toxicity, and sometimes improved seizure control. Further studies will provide a clearer picture of the limits to modern anticonvulsant therapy, the relative efficacy of individual drugs, and the potential for improved long-term prognosis.
D000375:Aging; D000927:Anticonvulsants / Q000009:adverse effects / Q000097:blood* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000453:epidemiology; D006801:Humans; D011379:Prognosis
D000927:Anticonvulsants