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Abstract
Background: Carbamazepine (CBZ) is a first-generation anticonvulsant drug. Hence, in certain cases, therapeutic drug monitoring (TDM) supports pharmacotherapy. Methods: The presented research was based on a retrospective analysis including 710 ambulatory and hospitalized patients treated with CBZ between the years 1991 and 2011. The method used for the determination of the CBZ concentration was fluorescence polarization immunoassay (FPIA) performed using an Abbott GmbH TDx automatic analyzer, with the therapeutic range for carbamazepine being 4–12 µg/mL. Results: The therapeutic range was observed more often in patients between 3 and 17 years of age compared with the population ≥18 years of age (73.5% vs. 68.8%). The therapeutic level was exceeded less frequently in the population between 3 and 17 years of age despite them being given a significantly higher dose per kilogram of body weight than in the population ≥18 years of age (13.64 mg/kg vs. 10.43 mg/kg, p < 0.0001). Patients ≥18 years of age were statistically significantly more likely to be in the group with a suspected drug overdose (73.9% vs. 26.1%), and suicide attempts only occurred in elderly patients (100.0% vs. 0.0%, p = 0.003). Conclusion: The results of the TDM of CBZ showed that only 71% of all samples were at the therapeutic level. To ensure the maximum efficacy and safety of the therapy, it is necessary to monitor the concentration of CBZ regardless of sex and age.
Highlights
Carbamazepine (CBZ), one of the classic antiepileptic drugs (AEDs), was introduced in the 1960s and 1970s
In the study population, regardless of the number of doses taken per day, the median concentration of CBZ was within the therapeutic range and did not differ statistically (Table 2)
The therapeutic drug monitoring (TDM) results of CBZ were evaluated for both sexes in different age groups, where epilepsy was the predominant diagnosis (94.6%)
Summary
Carbamazepine (CBZ), one of the classic antiepileptic drugs (AEDs), was introduced in the 1960s and 1970s. It still plays a dominant role in epilepsy treatment as the first-line drug of choice (DOC), especially for different focal epileptic syndromes [1,2,3]. This drug is used, among other things, to treat idiopathic neuralgias of the trigeminal and glossopharyngeal nerves and pain caused by diabetic neuropathy. Pharmacokinetics in patients above 3 years of age are comparable to those in adults [5]. To ensure the maximum efficacy and safety of the therapy, it is necessary to monitor the concentration of CBZ regardless of sex and age
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