Antiepileptic Drug Level Monitoring

摘要

Evidence Summary Antiepileptic drug level monitoring has been routinely used since the advent of reliable assays of phenytoin levels in the 1960s.1,2 At times, drug level monitoring is unnecessary and possibly harmful (e.g., indiscriminate antiepileptic drug level monitoring in a stable patient may create the potentially dangerous situation of treating the level and not the patient).3 A study of antiepileptic drug level determinations at a tertiary care center revealed that only 27 percent were appropriately indicated, and of those, one half were sampled incorrectly.4 One RCT assessed the impact of antiepileptic drug level monitoring in patients with new-onset epilepsy.5 The study enrolled 180 patients with partial or idiopathic generalized epilepsy treated with carbamazepine (Tegretol), valproate (Depakote), phenytoin, phenobarbital, or primidone (Mysoline).