Lamotrigine therapeutic thresholds

Seizure : the Journal of the British Epilepsy Association
Marianne Søndergaard KhinchiP Wolf

Abstract

To evaluate therapeutic drug monitoring (TDM) of lamotrigine (LTG) with establishment of individual therapeutic thresholds (TT) in outpatients of a tertiary epilepsy centre on monotherapy. In the outpatient clinic of the Danish Epilepsy Centre, Dianalund, all patients treated in 2004 with LTG monotherapy were identified. Patients who had not reported seizures or adverse reactions in the last 6 months were considered seizure free and well-medicated on LTG monotherapy, and were further evaluated. Plasma levels from routine LTG TDM obtained by reversed-phase high-pressure liquid chromatography (HPLC) during up-titration were used to calculate the TT for each patient as the mean of the highest subtherapeutic and the lowest therapeutic level. Eighty-two patients undergoing LTG monotherapy were reported seizure free as defined above. In 34 the TT could not be calculated because they became seizure free on the first chosen dose. TTs of the remaining 48 patients ranged from 4.0 to 42.0 micromol/l. There were no differences between children and adults, and between generalized and localization-related epilepsies. The therapeutic levels of patients with undefined TT tended to be lower. The level-dose ratio in both groups varied only moder...Continue Reading

References

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Citations

Jan 23, 2016·European Journal of Clinical Pharmacology·Kazuyuki InoueKunihiko Itoh
May 11, 2015·International Journal of Legal Medicine·Lucia TattoliMichael Tsokos
Jan 10, 2012·Biochemical Pharmacology·David DickensMunir Pirmohamed
Apr 15, 2008·Epilepsy & Behavior : E&B·Kirsten Annette NielsenPeter Wolf
Apr 1, 2016·Acta Neurologica Scandinavica·P RameyB Abou-Khalil
Oct 28, 2011·Epilepsy Research·Vishal PatelRoy G Beran
Mar 9, 2010·Thérapie·Danièle Bentué-FerrerUNKNOWN le groupe Suivi Thérapeutique Pharmacologique de la Société Française de Pharmacologie et de Thérapeutique
Oct 22, 2016·Drugs in R&D·Shery Jacob, Anroop B Nair
Oct 11, 2008·Journal of Separation Science·Seyed Ahmad Mohajeri, Soltan Ahmed Ebrahimi
Mar 1, 2019·Therapeutic Drug Monitoring·Christian Brandt
Feb 28, 2008·Nature Clinical Practice. Neurology·Peter Wolf
Mar 19, 2019·Therapeutic Drug Monitoring·Christian Brandt
Jun 27, 2018·Molecular Pharmaceutics·David DickensAnne T Nies

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