Possible roles for frequent salivary antiepileptic drug monitoring in the management of epilepsy

Herkes G.K. and Eadie M.J. (1990) Possible roles for frequent salivary antiepileptic drug monitoring in the management of epilepsy. Epilepsy Research, 6 2: 146-154. doi:10.1016/0920-1211(90)90090-I


Author Herkes G.K.
Eadie M.J.
Title Possible roles for frequent salivary antiepileptic drug monitoring in the management of epilepsy
Journal name Epilepsy Research   Check publisher's open access policy
ISSN 0920-1211
Publication date 1990-01-01
Sub-type Article (original research)
DOI 10.1016/0920-1211(90)90090-I
Volume 6
Issue 2
Start page 146
End page 154
Total pages 9
Subject 2728 Clinical Neurology
2735 Pediatrics, Perinatology, and Child Health
2808 Neurology
Abstract Salivary levels of phenytoin, phenobarbitone, carbamazepine and carbamazepine-epoxide correlate with the simultaneous plasma water levels of these substances, after correcting for the effects of pH differences between saliva and plasma in the case of phenobarbitone. Saliva is easy and painless to collect, and salivary levels of the drugs are conveniently measured. Frequent (often daily) monitoring of pre-dose morning anticonvulsant drug concentrations in saliva over periods of weeks or months in 3 groups of epileptic subjects showed that (i) in some but not all poorly controlled epileptic patients seizures tended to occur on days when salivary anticonvulsant levels were lower than on non-seizure days, (ii) in such subjects it was possible to estimate an anticipated optimal drug concentration and dose to minimize seizure activity from the plot of seizure frequency against drug concentrations, (iii) in women with 'catamenial' epilepsy, salivary anticonvulsant levels were lower on perimenstrual days than at mid-cycle in half of the subjects studied, and (iv) in pregnant epileptic women the time course of the change in drug levels relative to dose could be followed more closely throughout pregnancy and the post-natal period than was practicable when using blood level measurements. Frequent measurement of salivary anticonvulsant concentrations appears a promising and inexpensive adjunct to the investigation and management of certain problem areas in epilepsy.
Keyword Anticonvulsants
Catamenial
Saliva
Seizures
Uncontrolled
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: Scopus Import
 
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