Postictal serum levels of antiepileptic drugs for detection of noncompliance.
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.
Specht
U
U
Rehabilitation Unit and Clinic Mara 1, Bethel Epilepsy Center, Maraweg 21, D-33617 Bielefeld, Germany. usp@mara.de
Elsner
H
H
May
T W
TW
Schimichowski
B
B
Thorbecke
R
R
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
D000927:Anticonvulsants