Seizure freedom for patients with epilepsy, treatment aspects and quality of life.

Intricate relationships between pharmacokinetic, psychological and psychiatric factors may jeopardize seizure control in epilepsy. Several generic leveteracitam preparations have been marketed. Switching patients from branded antiepileptic drug to generic alternative, with the same active ingredient, is often a challenging task. The overall aim is to optimize seizure control, and to enhance vigilance concerning psychiatric co-morbidity, in patients with epilepsy. Safe generic switch in epilepsy with safe follow-up routines will increase substitution numbers and diminish patients and doctors worries.

We work on evidence for adequate clinical follow-up routines during generic switch, and after loss of seizure control, including optimized routines for therapeutic drug monitoring.

If routines for serum concentration drug sampling at emergency visits due to break through seizures become standardized, toxicity from unmotivated and inadequate AED dose escalations will be avoided. Enhanced vigilance concerning psychiatric co-morbidity in epilepsy will ensure adequate anti-depressant treatment is prescribed. Hence, adherence to drug regimens for a larger number of persons with epilepsy will be facilitated. Unnecessary suffering and hospital visits can be avoided, with cost savings as a consequence.