Abstracts

Rationale: Eslicarbazepine (ESL) is a relatively new antiepileptic drug (AED), receiving FDA approval in 2013. There are limited reports regarding blood levels achieved with optimal dosing and pharmacokinetic data related to rate of metabolism/elimination. Methods: We retrospectively reviewed 32 patients treated with ESL in the past 5 years at the Ochsner Epilepsy Center and documented each patient’s doses and corresponding blood levels as well as changes in seizure frequency. Clearance was calculated as dose (mg)/blood level (ug/ml). Results: Clearance: values varied and were separated into three strata, 18-42 L/D (slow metabolizers), 43-64 L/D (average metabolizers) and 65-109 L/D (fast metabolizers). Seizure outcome: Of the 32 patients, 6 were excluded due to lack of blood levels or documented seizure frequency. Of the remaining 26 patients, 12 patients (42%) achieved seizure freedom and 6 patients achieved 50-75% seizure reduction. Of those who achieved seizure freedom, ESL doses ranged from 400-2400 mg with blood levels ranging from 8-45 ug/ml, with mean blood level of 23 ug/mL. In those who achieved seizure reduction, doses ranged from 800-2400 mg with blood levels ranging from 15-42 ug/mL and mean blood level of 24 ug/mL.Of the 8 patients who did not show improvement in seizure frequency, 5 patients failed multiple monotherapies or were on more than 2 AEDs; 1 patients was taken off medication for side effects of hyponatremia,  1 patient had dose reduction for side effect of dizziness and 1 had worsening seizure frequency on ESL. Conclusions: Eslicarbazepine appears to be a promising AED, given the impact on seizure control.We found that patients metabolize ESL differently and blood level monitoring will help optimize treatment. Funding: None