Therapeutic drug monitoring (TDM): an aid to anti-epileptic drug (AED) therapy in Zimbabwe: a review.

Therapeutic drug monitoring as an aid to maximal anti-epileptic drug therapy in Zimbabwe was reviewed. The rationale behind therapeutic drug monitoring is that the therapeutic response to most anti-epileptic drugs correlates with the concentration in the blood rather than with the dose and that within an optimum therapeutic range, the majority of patients experience maximum benefit with minimum toxicity. This review highlights the fact that therapeutic drug monitoring is required to optimise anti-epileptic drug therapy because it is a predictor of drug compliance; it is ideal for dosage adjustment: it is a good indicator for confirming clinical diagnosis of intoxication and in poly-pharmacy it can be used to identify a culprit compound and in pregnancy and paediatric populations it is ideal for dosage individualization since changes are rapid. TDM of AED is recommended in the 'intractable' seizure group for our setting.