pregnancy, epilepsy, antiepileptic drugs, therapeutic drug monitoring

The paper discusses long-term trends in the utilization of antiepileptic drugs during pregnancy and reports an analysis of their concentations at delivery. The reguest forms for routine therapeutic drug monitoring and concentrations of antiepileptic drugs at delivery collected between the years 1991-2006 were used as the data source. Monotherapy versus polytherapy, the utilization of individual antiepileptic drugs and combinations, and concentations were monitored in a group of 235 pregnancies within three 5-year periods. Monotherapy was used in 61 % in the years 1991-1995, in 68% in the years 1996-2000, and in 75 % in the years 2001-2006. During the 1 st period, the most frequently prescribed agents were phenytoin, carbamazepine and primidone, during the 2 nd period, carbamazepine, phenytoin, and valproic acid, and during the 3 rd period, carbamazepine, lamotrigine, and valproic acid. Concentations were mostly under the therapeutics range with an exception ofcarbamazepine and primidone.