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Epilepsy is one of the most common neurologic disorders, affecting about 1% of the U.S. population. More than 30% of patients with epilepsy experience either adverse effects or inadequate seizure control with traditional antiepileptic medications. Gabapentin is a new antiepileptic drug with a unique mechanism of action that enhances nonsynaptic release of gamma aminobutyric acid GABA) release. Pharmacokinetic advantages include no protein binding, no active or toxic metabolites, renal excretion, and few drug interactions. No serious or idiosyncratic effects have been identified. The major side effects are mild sedation, nausea, behavioral changes, movement disorders, and weight gain. The recommended initial dose is 300 mg daily. The dosage can be increased at 300 mg intervals daily up to 900 to 4800 mg per day. The circulating half life is 5 to 7 days. Therapeutic range is 2.0 - 12.0 ug/mL. Levels >25.0 ug/mL are considered critical values. Trough levels should be drawn one hour before the next dose. Specimen requirement is one plain red top tube or one lavender top (EDTA) tube. |
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