Therapeutic Drug Monitoring of Anticonvulsants

Since early 2017 the analyses of anticonvulsants has been transferred from the pharmacological laboratory of the „Gesellschaft für Epilepsieforschung” in Bielefeld to the accredited MVZ Labor Krone, which looks back at a long successful cooperation with the centre for epilepsy Bethel.

We offer a fast and reliable drug monitoring of traditional and new anticonvulsants.

Range of services: Which anticonvulsants can be analyzed?

Traditional anticonvulsants	New anticonvulsants
Bromide	Brivaracetam
Carbamazepine	Felbamate
+ Carbamazepin-Epoxide	Gabapentin
Ethosuximide	Lacosamide
Mesuximide*	Lamotrigine
Phenobarbital	Levetiracetam
Phenytoin (DPH)	Oxcarbazepine/Eslicarbazepine*
Primidone	Perampanel
Sultiame	Pregabalin
Valproic acid	Rufinamide
	Stiripentol
	Topiramate
	Vigabatrin
	Zonisamide

* the active metabolite is analysed

Furthermore, we offer drug level monitoring for a series of other drug groups like

benzodiazepines (e. g. Clobazam/DM-Clobazam), antidepressants, antipsychotics and immunosuppressants

How are anticonvulsants analyzed

High-performance liquid chromatography (HPLC)
Liquid chromatography–mass spectrometry (LC-MS/MS)
Photometric tests
Antibody based tests (Immunoassay)

Notes on the interpretation of the anticonvulsant concentrations - what should be considered?

A series of factors can influence the measured concentration, for example:

Time of day and intake of the last dose,depending on the half-life of the anticonvulsant)
Co-medication (interaction with other anticonvulsants, antibiotics etc.)
Change in body weight
Pregnancy
Intercurrent liver or kidney diseases
Age and metabolism of the patient

Medical reports

The medical reports can be transmitted in paper form, as telefax or electronically., They contain reference ranges for the “average therapeutic concentration range”. However, the overall clinical impression of each patient should be taken into account when adjusting the medication in regard to the test results..

Shipping of samples - what should be considered?

The analysis of anticonvulsants requires 0.5 mL serum or 1.0 mL whole blood
Samples can be shipped by room temperature
Our request forms can be ordered via phone 0522 8076184 or medikamente@laborkrone.de.
Order free of charge shipping material under 0522 8076444

Please ensure the patient’s name is printed on the request form as well as on the sample material. Do not use photocopies of the request form.

Existing customers who already use our barcode book, can label the request form and samples with barcodes.

Further information on relevant topics

MPA Fitness to Drive

In most industrial countries if a driver loses his driving license as a result of drug or alcohol offense he has to prove abstinence for several months up to one year. The exact conditions of drug testing in urine or hair are different from country to country and depend on the individual situation.

Therapeutic Drug Monitoring (TDM)

Many diseases can now be successfully treated with the adequate medication. In order to achieve the desired effect, to minimize side-effects and to avoid over- as well as under-treatment, it may be essential to control the blood concentration of the administered medications.

Gene Analyses

In rare cases, the origin of a blood or urine sample is called into question. For these instances, we collaborate with a partner laboratory to conduct a genetic comparison between samples, to unmistakably identify the patient.