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Multiple Oral Dose (Antiepileptic) - Non-linear

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Ms TP is young lady with complex psychomotor seizures.  She was placed on an oral regiment of an anti-convulsant. Based on standard therapeutic recommendations, her starting dose was 200mg twice daily.

This drug has a half-life of about 10-22 hours but exhibits non-linear pharmacokinetics due largely to saturable drug metabolism. 

Current evidence suggests that to achieve adequate suppression of seizures, the trough concentrations should be above 0.01 mg/mL. However, concentrations above 0.02 mg/mL may be associated with increasing risks of drowsiness, suicidal ideation, and possible risks of arrhythmias.

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