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Epilepsy Behav. 2003 Oct;4(5):487-95.

Postictal serum levels of antiepileptic drugs for detection of noncompliance.

Author information

1
Rehabilitation Unit and Clinic Mara 1, Bethel Epilepsy Center, Maraweg 21, D-33617 Bielefeld, Germany. usp@mara.de

Abstract

Medication noncompliance (NC) is thought to be a major cause of insufficient seizure control. In an explorative study we investigated whether postictal serum levels (PISLs) of antiepileptic drugs (AEDs) are a reliable indicator of NC. Young adults with epilepsy on a stable AED regimen were asked to contact medical service as soon as possible when a seizure occurred to obtain serum levels of their AEDs. PISLs were compared with the mean value of two routine serum levels of the same medication. PISLs lower than 50% of the individual reference value were regarded as an indicator of NC. PISL samples in 61 seizures of 52 patients treated mainly with carbamazepine, valproic acid, or lamotrigine were evaluated. A drop in serum levels >50% indicating NC was noted in 44.3% of the seizures. Determination of PISLs seems to be a simple and useful method for detecting or ruling out irregular intake patterns as a cause of "breakthrough" seizures.

PMID:
14527489
[Indexed for MEDLINE]

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