Logo Medical Science Monitor

Call: +1.631.470.9640
Mon - Fri 10:00 am - 02:00 pm EST

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

02 October 2008

Limited place for plasma monitoring of new antiepileptic drugs in clinical practice

Salvatore Striano, Pasquale Striano, Domenico Capone, Francesco Pisani

Med Sci Monit 2008; 14(10): RA173-178 :: ID: 869402

Abstract

Therapeutic drug monitoring (TDM) has been recognized as a useful guide in the clinical management of patients with epilepsy, in particular those on therapy with traditional antiepileptic drugs (AEDs). The demonstration of significant drug interactions and the introduction of the concept "therapeutic range" have also contributed to the view that monotherapy should be considered the "gold standard" in the treatment of epilepsy. Ten new AEDs have been approved and released to the market in the last fifteen years. The most obvious consequence has been an increased number of patients on polytherapy. In general, newer AEDs have better and more predictable pharmacokinetics than older AEDs and usually show lower risk of interactions leading to toxicity as well as large therapeutic indexes. This pragmatic review focuses on practical suggestions about the potential clinical usefulness of TDM of newer AEDs in relation to their mechanism of action and pharmacokinetic characteristics and in response to patient-specific problems. Overall, the usefulness of TDM of newer AEDs seems to be limited and its indiscriminate use is not justified. However, in selected cases or in response to a specific clinical question, a wise use of TDM of some new AEDs could represent a useful tool in the management of epileptic patients. Exceptions are thus represented by special conditions such as renal failure, dialysis, ascertainment of non-compliance, and pregnancy. For some new AEDs, TDM could be selectively and properly used in response to a single patient-specific pharmacokinetic or pharmacodynamic issue.

Keywords: Epilepsy - drug therapy, Clinical Trials as Topic, Drug Monitoring, Pregnancy, Anticonvulsants - therapeutic use

Add Comment 0 Comments

Editorial

01 April 2025 : Editorial  

Editorial: Rapid Testing for the Avian Influenza A(H5N1) Virus is Urgently Required as Infections in Poultry and Dairy Cows are on the Rise, and so is Transmission to Humans

Dinah V. Parums

DOI: 10.12659/MSM.949109

Med Sci Monit 2025; 31:e949109

0:00

In Press

Review article  

Global Guidelines and Trends in HPV Vaccination for Cervical Cancer Prevention

Med Sci Monit In Press; DOI: 10.12659/MSM.947173  

0:00

Clinical Research  

Serum Prolidase and Ischemia-Modified Albumin Levels in Neural Tube Defects: A Comparative Study of Myelome...

Med Sci Monit In Press; DOI: 10.12659/MSM.947873  

0:00

Clinical Research  

Impact of Depression, Fatigue, and Pain on Quality of Life in Slovak Multiple Sclerosis Patients

Med Sci Monit In Press; DOI: 10.12659/MSM.947630  

Clinical Research  

Longitudinal Evaluation of Metabolic Benefits of Inactivated COVID-19 Vaccination in Diabetic Patients in T...

Med Sci Monit In Press; DOI: 10.12659/MSM.947450  

0:00

Most Viewed Current Articles

17 Jan 2024 : Review article   7,960,158

Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron Variant

DOI :10.12659/MSM.942799

Med Sci Monit 2024; 30:e942799

0:00

16 May 2023 : Clinical Research   702,953

Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...

DOI :10.12659/MSM.940387

Med Sci Monit 2023; 29:e940387

0:00

01 Mar 2024 : Editorial   29,945

Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and ...

DOI :10.12659/MSM.944204

Med Sci Monit 2024; 30:e944204

0:00

28 Jan 2024 : Review article   23,915

A Review of IgA Vasculitis (Henoch-Schönlein Purpura) Past, Present, and Future

DOI :10.12659/MSM.943912

Med Sci Monit 2024; 30:e943912

0:00

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750