Therapeutic drug monitoring of newer antiepileptic drugs

Therapeutic drug monitoring (TDM) of antiepileptic drugs (AEDs) has been in clinical use for more than three decades. Its value has, however, been questioned recently for several reasons, e. g., the occurrence of newer AEDs, for which the use of TDM has to be evaluated, but also because of financial strains on health systems. The current review aims at assessing the use of TDM in newer AEDs, i.e., those that entered the market since the beginning of the 1990s. As some have been licensed only recently and others are only in very limited use, either because of orphan drug status or because of limited efficacy or potentially severe adverse events, only limited data exist for some of the newer AEDs. General considerations are made in the review, and each new AED is discussed, and, in some cases preliminary, assessment of the use of TDM is given.