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Journal of Clinical and Applied Neurosciences                            Volume 2; Issue 1                                   Jan-Jun 2017
ORIGINAL ARTICLE
A Pilot Study Comparing the Dose and Serum Drug Levels with Seizure Control in Patients on Carbamazepine Monotherapy
Adedunni W OLUSANYA1, Mustapha DANESI2,3


AFFILIATIONS
1Department of Pharmacology Therapeutics and Toxicology College of Medicine,University of Lagos, NGERIA
2Department of Medicine College of
Medicine, University of Lagos, NIGERIA
3Lagos University Teaching Hospital, Idi-Araba, Lagos NIGERIA

CORRESPONDING AUTHOR
Adedunni W OLUSANYA
Department of Pharmacology Therapeutics and Toxicology
College of Medicine,University of Lagos, NIGERIA

E-mail: dedunolusanya@gmail.com <mailto:dedunolusanya@gmail.com>
Phone: +234 812 664 8460

DISCLOSURE: None

Received: 18th January, 2017
Accepted: 4th April, 2017
ABSTRACT

Background
: The management of epilepsy involves titrating the dose of an antiepileptic drug to a maximum dose before switching over to a second agent. Measurement of serum levels of antiepileptic medications is indicated to determine drug levels in patients with uncontrolled seizure. Carbamazepine is one of the commonly used antiepileptic drugs in this environment. Studies have shown individual variations in drug dose and serum levels at which seizures are controlled.
Objectives: The aims of this study are to compare seizure control rates in patients on a high dose to low dose carbamazepine and to relate serum drug levels of carbamazepine to seizure control.
Methodology: This study consisted of  77 patients on carbamazepine monotherapy (for at least 9 months) for the treatment of epilepsy. Seizures were described as being fully controlled when there was seizure freedom for the preceding 6 months or more. The dose of carbamazepine was documented and serum level of carbamazepine was determined using high-performance liquid chromatography.
Results: Patient who were  on a dose of 400mg per day  were more likely to be controlled compared to those on higher doses (p = 0.011).  The mean serum level of carbamazepine in patients who were controlled  was lower (9.206.28mg/l) compared to 11.505.52mg/l in uncontrolled patients (p = 0.178).
Conclusions:  Higher doses of carbamazepine was not associated with an increase in seizure control rates. Seizure control was achieved at widely varying levels of carbamazepine. This suggests that seizure controlled is not solely dependent on serum drug levels.

Keywords
: Epilepsy, antiepileptic drugs, therapeutic drug monitoring