Pediatric antiepileptic drug therapeutic drug monitoring

Antiepileptic drugs( AEDs) are the mainstay of epilepsy treatment and there are now 27 licensed AEDs in total for the treatment of patients with epilepsy. This has led to an increasingly widespread application of therapeutic drug monitoring( TDM)making AEDs among the most common medications for which TDM is performed. For the older first generation AEDs( carbamazepine,ethosuximide, phenobarbital, phenytoin, primidone and valproic acid) much data has accumulated in this regard. However, increasingly this is occurring for the new AEDs (eslicarbazepine acetate, felbamate,gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, perampanel, piracetam, pregabalin, retigabine, rufinamide, stiripentol, tiagabine, topiramate, vigabatrin and zonisamide). The aim of the present paper is to provide an overview of the indications for AEDs TDM in children. Practical issues such as choice of sample type, sample collection and processing and the concept of the reference range are discussed