Monitoring and antiepileptic drug safety.

Treatment of patients with epilepsy strives for complete seizure control without intolerable drug side effects. Independent of blood drug levels, toxic effects allow titration to efficacy; however, allergic reactions, metabolically or genetically determined drug-induced illnesses, and idiosyncratic effects of drugs, while rare, may be life-threatening. Monitoring is an attempt to detect serious systemic toxic reactions of antiepileptic drugs in time to intervene and protect patients. The process begins with the disclosure to patients and family members of all information required for an informed decision delivered within the framework of risks and benefits. This review provides guidance regarding designing a monitoring strategy for patients requiring chronic treatment with antiepileptic drugs.