Pharmacokinetics and Therapeutic Drug Monitoring of Newer Antiepileptic Drugs

Recently a newer generation of antiepileptic drugs has been developed and rational polytherapy has become popular in everyday clinical practice for epilepsy management. All of newer antiepileptic drugs (AED) have undergone extensive clinical studies, but the information on the relationship between concentrations and effects is scarce. The concentration can depend on the individual variation, but explain the efficacy and toxicity in individual patient management. We assess the potential value of measuring the level of newer AED, which is one of therapeutic drug monitoring (TDM). The value of TDM is discussed based on pharmacokinetic characteristics and drug interactions. Although routine TDM in general cannot be recommended, TDM of the newer AED may be of value in selected cases.