ASSESSMENT OF ANTICONVULSANT THERAPEUTIC DRUG MONITORING IN THE TREATMENT OF EPILEPTIC SEIZURES

This study seeks to evaluate the existing evidence about therapeutic drug monitoring (TDM) in the context of epileptic seizures and to analyze in-depth the role of TDM in refining treatment strategies for the 27 licensed antiseizure medications (ASMs). Epilepsy is a neurological disorder with recurrent seizures as its defining feature, and ASMs are essential for both seizure management and prophylaxis. For practically one-third of patients who continue to be treatment resistant, TDM acts as an important strategy to cope with the intricacies of epilepsy care, especially in difficult-to-manage groups such as the elderly, pregnant women, and patients with other chronic medical conditions. TDM measures certain drugs in the patient's blood to ensure these drugs are within the defined therapeutic range; efficacy is maximized while possible side effects are minimized. TDM enhances clinical outcomes by improving individualized control of seizures, leading to enhanced control of seizures with reduced risk of toxic effects, underscoring its importance in clinical practice. Studies demonstrate that pharmacist-led TDM interventions can significantly improve patient outcomes, with increased rates of effective seizure management and enhanced medication adherence. Because of the wide pharmacokinetic variability of ASMs, there is a noticeable variation in serum concentrations between patients. Therefore, the best way to guide patient management is to determine the specific therapeutic concentrations. To further individualize treatment approaches and optimize the use of ASMs, future developments would involve additional clinical toxicity and genetic variability indicators, ensuring the safety and efficacy of the overall treatment regimen.

Keywords: Antiseizure medications, Clinical pharmacology, Epilepsy, Neurological, Therapeutic drug monitoring, Translational research.