Sammanfattning
Purpose
«Optimal treatment with antiepileptic drugs for the individual
patient» is an important principle for patients
with epilepsy,
but also for the increasing
number of new patient groups
that use antiepileptic drugs.
The purpose of this review is to give an update of methods
and implementation
of clinical pharmacology for antiepileptic
drugs with focus on population and patient levels.
Material and methods
This article is based on experience and selected literature
from the authors’
research background.
Results
Two main approaches to study clinical
pharmacology
of antiepileptic
drugs are focused on. Changes in drug
utilisation
in epilepsy
and other indications as pain and
psychiatry, polytherapy and psychiatric comorbidity may
be investigated by pharmacoepidemiological
studies by
using the Norwegian Prescription Database. Such studies
may be used as guidance in the treatment of the individual
patient. Pharmacokinetic variability in individual patients and
special
patient groups like children, pregnant women and the
elderly may be studied by use of data from therapeutic drug
monitoring. Thus, dosage may be adjusted individually for
optimalisation of the treatment. Treatment challenges include
age-related changes in kinetics, interactions, pharmacogenetic
variability, burden of adverse effect and adherence.
Conclusion
Knowledge of use and monitoring of antiepileptic drugs in the
whole population and in selected patient groups is important
to achieve an optimal treatment in the individual patient.