Antiepileptic drug therapy. Fine tuning the dosage regimen

The first article in this series, published last month, acquainted readers with the basic principles of therapeutic drug monitoring and emphasized the value of this simple procedure in helping physician and patient reach their goal of optimal drug therapy. This month's article begins the analysis of specific therapeutic classes of drugs with a look at the antiepileptics. Because of some unique characteristics of these drugs and of epilepsy itself, fine tuning of the dosage regimen on the basis of concentrations of the drug in serum is crucial to achieving seizure control without toxicity. Dr Welty and associates discuss therapeutic ranges, side effects, and drug interactions of four major antiepileptics and present a detailed therapeutic plan for each.