Therapeutic drug monitoring of lamotrigine.
OBJECTIVE
To evaluate the usefulness of routine monitoring of serum lamotrigine concentration.


METHODS
Literature was accessed through MEDLINE (1990-January 2001). Key search terms included lamotrigine, pharmacokinetics, and epilepsy.


RESULTS
A decision-making algorithm was used to evaluate the clinical evidence to support or refute the routine use of serum lamotrigine concentrations to adjust doses. The value of serum lamotrigine concentration monitoring remains controversial, primarily because clear relationships between concentration and pharmacologic response (either efficacy or toxicity) have not been demonstrated.


CONCLUSIONS
Serum concentration monitoring of lamotrigine is not recommended as a tool for routine dose adjustment.
Chong
Elaine
E
Department of Pharmacy, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada.
Dupuis
L Lee
LL
D000927:Anticonvulsants / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D001682:Biological Availability; D002986:Clinical Trials as Topic; D016903:Drug Monitoring / Q000379:methods*; D004827:Epilepsy / Q000188:drug therapy; D006801:Humans; D000077213:Lamotrigine; D016239:MEDLINE; D012189:Retrospective Studies; D012196:Review Literature as Topic; D016896:Treatment Outcome; D014227:Triazines / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use
D000927:Anticonvulsants; D014227:Triazines; D000077213:Lamotrigine