Therapeutic profile of antiepileptics in patients from the Wilaya of Batna. A retrospective study on 106 cases.

Introduction. Therapeutic monitoring of conventional antiepileptic drugs is an essential approach to optimize the management of epileptic patients. It depends on the pharmacokinetics of these molecules and is based on regular assessment of their clinical efficacy and adverse effects. Monitoring plasma levels of valproic acid, carbamazepine, and barbiturate allows dosage adjustment to achieve an effective therapeutic concentration while minimizing the risk of toxicity. Objective. The objective of our study is to evaluate the therapeutic balance profile of antiepileptic drugs in epileptic patients monitored at the toxicology laboratory of Batna University Hospital. We also aim to examine the influence of certain sociodemographic factors on this balance, to optimize treatment management and improve clinical outcomes for patients. Materials and methods. This is a descriptive retrospective study, carried out between January 2021 and April 2022, at Batna University Hospital. This study involved epileptic patients receiving treatment with valproic acid, carbamazepine and barbiturate, as monotherapy or polytherapy, whether admitted or in an outpatient setting. Their follow-up was carried out in the toxicology laboratory. Results. 58% of patients were male with a sex ratio of 1.38, epilepsy was diagnosed before the age of 5 years with a predominance of the adult age group in 56% of patients, 61% of the study population or 65 patients were on monotherapy against 39% in polytherapy or 41 patients, 86% of patients were on valproic acid alone, 5% were on carbamazepine alone, however phenobarbital was always used in association. 41 patients on valproic acid were balanced with a C0 between 50 and 100 µg/mL; however, 53 patients were underdosed hence the need to associate patients with other antiepileptic drugs, in our study the female sex was more balanced than the male sex. Conclusion. Rigorous therapeutic monitoring of antiepileptics is fundamental for treatment optimization; this action is recommended to ensure effective control and minimize associated risks and adverse effects related to treatment, particularly in a context where disparities in the pharmacogenetic specificities of these molecules can impact therapeutic efficacy on epileptic seizures.