KADAR PLASMA KARBAMAZEPIN PADA EPILEPSI LOBUS TEMPORAL/CARBAMAZEPINE PLASMA LEVEL IN TEMPORAL LOBE EPILEPSY

Introduction: Carbamazepine (CBZ) is drug of choice in the management of temporal lobe epilepsy (TLE), a most common epilepsy syndrome. Nevertheless its plasma level is hard to be predicted due to the auto-induce nature of CBZ. A 400-1600mg dosage range were equal to 4-12mcg/ml plasma level of KBZ. A number of patients are positively respond to low dose of KBZ while other showed sign of intoxication prior to maximum dose. Aims: To find out about carbamazepine plasma level in TLE patients. Methods: Comparative cross sectional study was performed at epilepsy outpatient clinic on Cipto Mangunkusumo hospital, Jakarta. TLE patient with normal albumin level, liver and kidney function tests was selected consecutively from December 2014 to 2016. Subjects were and divided into responsive and resistant groups based on seizure frequencies in the last 1 year. KBZ plasma level were measured by a validated high level chromatographic methods. Results: 61 subjects were selected with 24 subjects met criteria for responsive group while 37 into resistant. In responsive group, mean dosage of CBZ was 405.21±226.5mg and mean plasma level was 7.59±2.32mcg/mL. Meanwhile, in resistant group mean dosage was 819.59±333.71mg and plasma level was 10.21±2.47mcg/mL. Almost 25% of resistant group had CBZ plasma level >12mcg/mL. Most of resistant ones were using clobazam as politherapy. There were strong correlation between CBZ plasma level and dosage in each groups. Discussion: In 400mg of CBZ dosage in TLE responsive, the plasma reach relatively high level of therapeutics range. Meanwhile in resistant TLE with dosage around 800mg, the plasma levels of CBZ almost reach the upper safety margins of therapeutics range.