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Anticonvulsant monitoring in psychiatric practice

The State Hospital, Carstairs, Lanark ML11 8RP

AIMS AND METHOD

A Medline literature search revealed a large number of articles on anticonvulsant monitoring. More relevant articles were selected with the aim of summarising current best practice in this area.

RESULTS

Most articles were written to address monitoring in epilepsy and not psychiatric illness. Serum ranges should only be regarded as guidelines. Some patients may show toxic signs at therapeutic serum levels while others may show tolerance and require higher levels.

CLINICAL IMPLICATIONS

Appropriate monitoring of serum levels improves efficacy and enhances safety. Clinician ignorance may lead to inappropriate or inaccurate sampling with resultant adverse consequences for the patient.