Modern Methods for Analysis of Antiepileptic Drugs in the Biological Fluids for Pharmacokinetics, Bioequivalence and Therapeutic Drug Monitoring

Epilepsy is a chronic disease occurring in approximately 1.0% of the world's population. About 30% of the epileptic patients treated with availably antiepileptic drugs (AEDs) continue to have seizures and are considered therapy-resistant or refractory patients. The ultimate goal for the use of AEDs is complete cessation of seizures without side effects. Because of a narrow therapeutic index of AEDs, a complete understanding of its clinical pharmacokinetics is essential for understanding of the pharmacodynamics of these drugs. These drug concentrations in biological fluids serve as surrogate markers and can be used to guide or target drug dosing. Because early studies demonstrated clinical and/or electroencephalographic correlations with serum concentrations of several AEDs, It has been almost 50 years since clinicians started using plasma concentrations of AEDs to optimize pharmacotherapy in patients with epilepsy. Therefore, validated analytical method for concentrations of AEDs in biological fluids is a necessity in order to explore pharmacokinetics, bioequivalence and TDM in various clinical situations. There are hundreds of published articles on the analysis of specific AEDs by a wide variety of analytical methods in biological samples have appears over the past decade. This review intends to provide an updated, concise overview on the modern method development for monitoring AEDs for pharmacokinetic studies, bioequivalence and therapeutic drug monitoring.

Impact of Antiepileptic Drugs on Cognitive Function of Patients with Epilepsy / 中国康复理论与实践

@#Objective To explore the impact of the different antiepileptic drugs on cognitive function in patients with epilepsy.Methods There are 280 cases of patients with epilepsy from Department of Neurology in our hospital out-patient and hospitalization, while 32 cases are the normal control group. The patients were randomly divided into groups of topiramate, carbamazepine and sodium valproate group and topiramate plus valproate combined therapy group. Wechsler Memory Scale was used by the patients before and after treatment to assess cognitive function, and compared with the normal group. Results Carbamazepine monotherapy group and the valproate group were no significant difference in areas of cognitive function belong to the normal level; Topiramate monotherapy group cognitive function was significantly lower than normal, the joint drug group was the most of the lower level of cognitive function. Conclusion Carbamazepine and valproate monotherapy were applied had the minor cognitive impairment, combination therapy of epilepsy in patients had severe cognitive impairment.