We aimed to determine the therapeutic drug monitoring (TDM) features and the relation to brain-derived neurotropic factor (BDNF) of frequently used new antiepileptic drugs (NAD) including lamotrigine (LTG), oxcarbazepine (OXC), zonisamide (ZNS) and lacosamide (LCM). Moreover, we investigated their effect on the quality of life (QoL).
Eighty epileptic patients who had been using the NAD, thirteen healthy participants were included in this cross-sectional study. The participants were randomized to groups. The QOLIE-31 test was used for the assessment of QoL. We also prepared and applied "Safety Test". HPLC method for TDM, ELISA method for BDNF measurements were used consecutively.
In comparison to healthy participants, epileptic participants had lower marriage rate (p=0.049), education level (p˂0.001), alcohol use (p=0.002). BDNF levels were higher in patients with focal epilepsy (p=0.013) and in those with higher education level (p=0.016). There were negative correlations between serum BDNF levels and serum ZNS levels (p=0.042) with LTG-polytherapy, serum MHD levels (10-monohydroxy derivative of OXC, p=0.041) with OXC-monotherapy. There was no difference in BDNF according to monotherapy-polytherapy, drug-resistant groups, regarding to seizure frequency. There was a positive correlation between total health status and QoL (p˂0.001). QOLIE-31 overall score (OS) were higher in those with OXC-monotherapy (76.5±14.5), OS (p˂0.001), seizure worry (SW, p=0.004), cognition (C, p˂0.001), social function (SF, p˂0.001) were different in maingroups. Forgetfulness was the most common unwanted effect.
While TDM helps the clinician to use more effective and safe NAD, BDNF may assist in TDM for reaching the therapeutic target in epilepsy.