Abstract
Despite advances in epilepsy therapeutics, some physicians feel uncomfortable with newer antiepileptic drugs (AEDs) due to difficulty in promptly obtaining blood levels to guide medication adjustment, and even when levels for newer AEDs are obtained, many practitioners feel they are not very useful. Lacking confidence in AEDs whose levels that cannot readily or expeditiously be measured, many clinicians share uncertainty about proper use of the newer AEDs and monitoring AED administration. Similarly, some epilepsy patients inflate the importance of AED blood level monitoring, feeling that blood levels falling within traditionally therapeutic ranges are a fail-safe for seizure control, regardless of their compliance or personal behavior aggravating seizure burden, such as poor sleep or use of illicit substances. This review examines the elusive concept of therapeutic AED blood levels and potential uses and abuses of blood level monitoring, reinforcing appropriate uses for blood levels to ensure compliance and adjust for altered AED pharmacokinetics in the context of aging and disease states, pregnancy, or drug interactions.
Keywords: Epilepsy, antiepileptic drugs, blood levels, monitoring
Current Neuropharmacology
Title: Monitoring Antiepileptic Drugs: A Level-Headed Approach
Volume: 7 Issue: 2
Author(s): Erik K. St. Louis
Affiliation:
Keywords: Epilepsy, antiepileptic drugs, blood levels, monitoring
Abstract: Despite advances in epilepsy therapeutics, some physicians feel uncomfortable with newer antiepileptic drugs (AEDs) due to difficulty in promptly obtaining blood levels to guide medication adjustment, and even when levels for newer AEDs are obtained, many practitioners feel they are not very useful. Lacking confidence in AEDs whose levels that cannot readily or expeditiously be measured, many clinicians share uncertainty about proper use of the newer AEDs and monitoring AED administration. Similarly, some epilepsy patients inflate the importance of AED blood level monitoring, feeling that blood levels falling within traditionally therapeutic ranges are a fail-safe for seizure control, regardless of their compliance or personal behavior aggravating seizure burden, such as poor sleep or use of illicit substances. This review examines the elusive concept of therapeutic AED blood levels and potential uses and abuses of blood level monitoring, reinforcing appropriate uses for blood levels to ensure compliance and adjust for altered AED pharmacokinetics in the context of aging and disease states, pregnancy, or drug interactions.
Export Options
About this article
Cite this article as:
St. Louis K. Erik, Monitoring Antiepileptic Drugs: A Level-Headed Approach, Current Neuropharmacology 2009; 7 (2) . https://dx.doi.org/10.2174/157015909788848938
DOI https://dx.doi.org/10.2174/157015909788848938 |
Print ISSN 1570-159X |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6190 |
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Neurotransmitters and Chemokines Regulate Tumor Cell Migration: Potential for a New Pharmacological Approach to Inhibit Invasion and Metastasis Development
Current Pharmaceutical Design Endocannabinoid System in Neurological Disorders
Recent Patents on CNS Drug Discovery (Discontinued) Recent Knowledge on Medicinal Plants as Source of Cholinesterase Inhibitors for the Treatment of Dementia
Mini-Reviews in Medicinal Chemistry In-person vs. eHealth Mindfulness-based Intervention for Adolescents with Chronic Illnesses: A Pilot Randomized Trial
Adolescent Psychiatry Editorial [ Hot topic:Psychogenomics and Psychiatric Practice, a New Paradigm (Guest Editor: Tih-Shih Lee)]
Current Psychiatry Reviews Role of Sirtuins and Calorie Restriction in Neuroprotection: Implications in Alzheimers and Parkinsons Diseases
Current Pharmaceutical Design Gastrodia Elata Bl Attenuates Cocaine-Induced Conditioned Place Preference and Convulsion, but not Behavioral Sensitization in Mice: Importance of GABAA Receptors
Current Neuropharmacology Metabolism of Benzodiazepine and Non-Benzodiazepine Anxiolytic-Hypnotic Drugs: an Analytical Point of View
Current Drug Metabolism Therapeutic Role of Zonisamide in Neuropsychiatric Disorders
Mini-Reviews in Medicinal Chemistry Effect of Nutrient Medium, Phytohormones and Elicitation Treatment on in-vitro Callus Culture of Bacopa monniera and Expression of Secondary Metabolites
The Natural Products Journal Nanotoxicity: The Toxicity Research Progress of Metal and Metal- Containing Nanoparticles
Mini-Reviews in Medicinal Chemistry Disorder in Milk Proteins: α-Lactalbumin. Part B. A Multifunctional Whey Protein Acting as an Oligomeric Molten Globular “Oil Container” in the Anti-Tumorigenic Drugs, Liprotides
Current Protein & Peptide Science Tau, Amyloid Beta and Deep Brain Stimulation: Aiming to Restore Cognitive Deficit in Alzheimer's Disease
Current Alzheimer Research Pharmacological Approaches for Treatment-resistant Bipolar Disorder
Current Neuropharmacology Glycyrrhizic Acid Ameliorates Cognitive Impairment in a Rat Model of Vascular Dementia Associated with Oxidative Damage and Inhibition of Voltage-Gated Sodium Channels
CNS & Neurological Disorders - Drug Targets Involvement of Cannabinoids in Cellular Proliferation
Mini-Reviews in Medicinal Chemistry Melatonin, its Metabolites and its Synthetic Analogs as Multi-Faceted Compounds: Antioxidant, Prooxidant and Inhibitor of Bioactivation Reactions
Current Medicinal Chemistry Clinical Studies with Targeted Toxins in Malignant Glioma
Reviews on Recent Clinical Trials Meet Our Editorial Board Member:
Current Neuropharmacology Ion Channels as Medicinal Targets of Biological Toxins: The Impact of Automated Patch-Clamp Electrophysiology
Current Topics in Medicinal Chemistry