Rationale and Comments
Antiepileptic drug level testing should not be routinely ordered when seizures are well controlled, and no adverse effect is suspected. The reference ranges should not be used as a rigid framework. The effectiveness and tolerability of treatments should be determined by the clinical responses. Antiepileptic drug levels should be ordered to address a specific question. Some examples include weight-based dosing adjustments in young children, adherence, suspected toxicity, and pregnant women.
Sponsoring Organizations
- American Epilepsy Society
Sources
- Cochrane Database of Systematic Reviews
Disciplines
References
- Eadie MJ Therapeutic drug monitoring – antiepileptic drugs. Br J Clin Pharmacol. 1998;46:185-193.
- Patsalos PN et al. Antiepileptic drugs—best practice guidelines for therapeutic drug monitoring: A position paper by the subcommission on therapeutic drug monitoring, ILAE Commission on Therapeutic Strategies. Epilepsia 2008;49(7):1239-1276.
- St. Louis EK Monitoring Antiepileptic Drugs: A Level-Headed Approach. Current Neuropharmacology, 2009;7:115-119.
- Affolter N et al. Appropriateness of serum level determinations of antiepileptic drugs. Swiss Med Wkly. 2003;133:591-597.
- Tomson T et al. Therapeutic monitoring of antiepileptic drugs for epilepsy (Review). Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD002216. Copyright © 2010 The Cochrane Collaboration. John Wiley & Sons, Ltd.
- Walters RJL et al. Inappropriate requests for serum anti-epileptic drug levels in hospital practice. Q J Med 2004;97:337-341.
- Stepanova D, Beran RG. The benefits of antiepileptic drug (AED) blood level monitoring to complement clinical management of people with epilepsy. Epilepsy Behav. 2015; 42:7-9.