Abstract Plasma ethosuximide level was monitored in 70 patients with absence (petit mal) seizures. Levels were linearly related to administered dose. Of 37 ambulatory patients with uncontrolled attacks, 38% (14) had levels below the 95% tolerance limit in contrast to 9% (5) of the controlled group. This difference, due to noncompliance with therapy, was eliminated by regular monitoring. Appropriate adjustment of plasma ethosuximide levels resulted in a reduction of seizures in 48% (18) of previously uncontrolled patients. Practical control of epilepsy increased from 64% (45) to 81% (57). Monitoring of plasma ethosuximide increases the effectiveness of therapy by the recognition of noncompliance and the individualization of drug requirements. References 1. Zimmerman FT, Burgemeister BB: A new drug for petit mal epilepsy . Neurology 8:769-775, 1958.Crossref 2. Goldensohn ES, Hardie J, Borea ED: Ethosuximide in the treatment of epilepsy . JAMA 180:840-842, 1962.Crossref 3. Livingston S, Pauli L, Najmabadi A: Ethosuximide in the treatment of epilepsy . JAMA 180:822-825, 1962.Crossref 4. Penry JK, Porter RJ, Dreifuss FE: Ethosuximide: Relation of plasma levels to clinical control , in Woodbury DM, Penry JK, Schmidt RP (eds): Antiepileptic Drugs . New York, Raven Press, 1972, pp 431-441. 5. Kutt H, Haynes J, McDowell F: Some causes of ineffectiveness of diphenylhydantoin . Arch Neurol 14:489-492, 1966.Crossref 6. Glazko AJ, Dill WA: Ethosuximide: Chemistry and methods for determination , in Woodbury DM, Penry JK, Schmidt RB (eds): Antiepileptic Drugs . New York, Raven Press, 1972, pp 413-415. 7. Lennox WG: The petit mal epilepsies: Their treatment with tridione . JAMA 129:1069-1074, 1945.Crossref 8. Gibberd FB: The prognosis of petit mal . Brain 89:531-538, 1966.Crossref 9. Holowach J, Thurston DL, O'Leary JL: Petit mal epilepsy . Pediatrics 30:893-901, 1962. 10. Lees F, Liversedge LA: The prognosis of "petit mal" and minor epilepsy . Lancet 2:797-799, 1962.Crossref 11. Janz D: Die Epilepsien-Spezielle Pathologie und Therapie . Stuttgart, Georg Thieme, 1969, p 94. 12. Marston MV: Compliance with medical regimens: A review of the literature . Nurs Res 19:312-323, 1970.Crossref 13. Buchthal F, Svensmark O, Schiller PJ: Clinical and electroencephalographic correlations with serum levels of diphenylhydantoin . Arch Neurol 2:624-630, 1960.Crossref 14. Lund M, Jørgensen RS, Kühl V: Serum diphenylhydantoin (phenytoin) in ambulant patients with epilepsy . Epilepsia 5:51-58, 1964.Crossref 15. Gibberd FB, et al: Supervision of epileptic patients taking phenytoin . Br Med J 1:147-149, 1970.Crossref
Archives of Neurology – American Medical Association
Published: Mar 1, 1973
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