If a Well‐Stabilized Epileptic Patient Has a Subtherapeutic Antiepileptic Drug Level, Should the Dose Be Increased? A Randomized Prospective Study

摘要: In an attempt to determine whether the dose of antiepileptic drug should be increased in epileptic patients who were seizure-free and had subtherapeutic serum levels, 79 with idiopathic generalized tonic-clonic seizures treated monotherapy [phenytoin (PHT) or phenobarbital (PB)] a level prospectively studied. Their last seizure was at least 3 months prior entry, no patient any clinical evidence toxicity. They randomized study arm A (keeping range) B (increasing until reached stayed therapeutic range). Over mean follow-up period 24 months, there significant difference between two arms occurrence seizures, but incidence neurotoxic side effects from increment. These results confirm impression that it is unnecessary increase despite concentration relatively well-stabilized patient, thus minimizing frequency adjustment need for expensive monitoring.