Therapeutic drug management (TDM) is the process of measuring an antiepileptic drug (AED) concentration in a patient’s biosample (usually serum or plasma) and using this information to manage that individual. The ILAE published the Best Practice Guidelines for monitoring AEDs to assist patient management (Patsalos et al. 2008). The document stresses that drug concentrations must be measured with a clear indication and interpreted critically, considering the whole clinical context.
TDM has been used as a tool to optimize treatment of epilepsy for almost 50 years, and while first-class evidence for its usefulness in improving clinical outcome is scarce, TDM continues to play a role in epilepsy management for three reasons:
