WASHINGTON, DC—The efficacy and tolerabil- ity of an antiepileptic drug (AED) depend on its
dose, formulation, and route of delivery, according to
an overview presented at the 67th Annual Meeting of
the American Epilepsy Society. For optimal outcomes,
these three factors should be personalized according to
the clinical situation and the individual patient’s characteristics, said Emilio Perucca, MD, PhD.
In terms of pharmacokinetics, “generally speaking,
flatter is better, meaning that producing steady, sus-
tained, stable AED concentrations in the blood, and
therefore in the brain, is considered to be in most cases the
ideal situation in epilepsy treatment,” said Dr. Perucca,
Professor of Pharmacology at the University of Pavia in
Italy. For most patients, seizures can occur at any time
of the day, “so if we maintain a therapeutic concentra-
tion that does not exceed the threshold above which
side effects occur throughout 24 hours, we are in the
best situation to treat the patient,” he added.
Do Sustained-Release Formulations Improve
Outcome?
For any AED, the minimal concentration required for
seizure control and the threshold concentration for
toxicity may differ from patient to patient. For some
drugs with short half-lives, using an immediate-release
formulation once or twice daily can produce high
Personalizing Treatment May Improve
Outcomes for Patients With Epilepsy
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Inside This Issue
continued on page 4
