title: Postictal serum levels of antiepileptic drugs for detection of noncompliance.
abstract: Medication noncompliance (NC) is thought to be a major cause of insufficient seizure control. In an explorative study we investigated whether postictal serum levels (PISLs) of antiepileptic drugs (AEDs) are a reliable indicator of NC. Young adults with epilepsy on a stable AED regimen were asked to contact medical service as soon as possible when a seizure occurred to obtain serum levels of their AEDs. PISLs were compared with the mean value of two routine serum levels of the same medication. PISLs lower than 50% of the individual reference value were regarded as an indicator of NC. PISL samples in 61 seizures of 52 patients treated mainly with carbamazepine, valproic acid, or lamotrigine were evaluated. A drop in serum levels >50% indicating NC was noted in 44.3% of the seizures. Determination of PISLs seems to be a simple and useful method for detecting or ruling out irregular intake patterns as a cause of "breakthrough" seizures.
authors.affiliation: Rehabilitation Unit and Clinic Mara 1, Bethel Epilepsy Center, Maraweg 21, D-33617 Bielefeld, Germany. usp@mara.de
authors.forename: U
authors.initials: U
authors.lastname: Specht
authors.forename: H
authors.initials: H
authors.lastname: Elsner
authors.forename: T W
authors.initials: TW
authors.lastname: May
authors.forename: B
authors.initials: B
authors.lastname: Schimichowski
authors.forename: R
authors.initials: R
authors.lastname: Thorbecke
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000097:blood* / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence; D012640:Seizures / Q000097:blood* / Q000503:physiopathology; D016312:Treatment Refusal
chemical_list: D000927:Anticonvulsants