Antiepileptic medication interactions

This overview of AEM interactions underscores the importance of understanding the pharmacokinetic properties of AEMs and demonstrates the need for careful analysis of AEM concentrations in situations in which combinations of AEMs are used. Although generalizations concerning the clinical significance of drug interactions can be made, major interpatient variations occur. Thus, whenever an AEM is added or deleted, concentrations of drugs should be measured. Refractory individuals or those with multiple seizure types may need polypharmacy, and, under these circumstances, both total and unbound concentrations may need to be measured. New AEMs may have the potential for clinically significant interactions. If these are not identified and understood early, the development and ultimate clinical usefulness of these new agents may be inhibited.