Personalized medicine for epilepsy based on the pharmacogenomic testing

: Currently a trial-and-error approach is employed to determine the most effective antiepileptic drug (AED) and dosage for a patient, and almost 30% of all patients are resistant to AED therapy. Introduction of personalized medicine for epilepsy based on pharmacogenomic testing is a new avenue for optimizing AED therapy. However, several crucial issues remain to be resolved before this initiative can be fully pursued. This article provides a critical review of the status and perspectives in the development of personalized medicine for epilepsy based on pharmacogenetic variations that may affect efficacy, tolerability, and safety of AEDs, such as variations in the genes encoding drug-metabolizing enzymes (e.g., cytochrome P450), or drug transporters (e.g., MDR1, MRP2).