Objective: We aimed to determine the therapeutic drug monitoring (TDM) features and
the relation to Brain-Derived Neurotrophic Factor (BDNF) of frequently used new antiepileptic
drugs (NADs) including lamotrigine (LTG), oxcarbazepine (OXC), zonisamide (ZNS) and lacosamide
(LCM). Moreover, we investigated their effect on the quality of life (QoL).
Methods: Eighty epileptic patients who had been using the NADs, and thirteen healthy participants
were included in this cross-sectional study. The participants were randomized into groups. The
QOLIE-31 test was used for the assessment of QoL. We also prepared and applied "Safety Test".
HPLC method for TDM, and ELISA method for BDNF measurements were used consecutively.
Results: 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 LTGpolytherapy,
serum MHD levels (a 10-monohydroxy derivative of OXC, p=0.041) with OXCmonotherapy.
There was no difference in BDNF according to monotherapy-polytherapy, drugresistant
groups, regarding seizure frequency. There was a positive correlation between total health
status and QoL (p˂0.001). QOLIE-31 overall score (OS) was higher in those with OXCmonotherapy
(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 the main groups. Forgetfulness was the most common
Conclusion: While TDM helps the clinician to use more effective and safe NADs, BDNF may assist
in TDM for reaching the therapeutic target in epilepsy.