What is the usefulness of serum concentrations of antiepileptic drugs (AEDs) in the management of epileptic seizures?

Updated: May 30, 2019
  • Author: David Y Ko, MD; Chief Editor: Selim R Benbadis, MD  more...
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Answer

As with any medical test, serum concentrations of AEDs help clinical decision making, but the patient's individual response should be the main consideration. For example, a patient with juvenile myoclonic epilepsy (JME) might be seizure free with a valproic acid level of 30 mcg/mL, which is typically considered “subtherapeutic,” but if the patient is seizure free, the level is therapeutic. Therefore, clinical judgment regarding how well the patient is doing (ie, no seizures, no adverse effects) should prevail over a laboratory reading. Again, many new AEDs do not have a recommended level for testing, which is cost saving for that AED relative to many other AEDs in which serum levels are obtained reflexively (thus, adding to the cost of care).


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