Pharmacological Therapeutic Monitoring of Three Major Anti-Epileptic Drugs in Mali

Introduction: Therapeutic drug monitoring is a means of monitoring anti-epileptic treatment. The objective of this study was to conduct therapeutic drug monitoring of the three most commonly prescribed anti-epileptic drugs in Mali. Methods: This was a cross-sectional, prospective study conducted over an eight-month period. It focused on the pharmacological therapeutic follow-up of carbamazepine (CBZ), phenobarbital (PB), and valproic acid (VPA) in 80 epilepsy patients monitored at the Neurology Department of Point G University Hospital. Results: The majority of participants were aged between 18 and 70 (65%). Generalised motor seizures were more common (76.20%). Carbamazepine was the most commonly prescribed drug (60.32%), followed by phenobarbital (20.63%) and valproic acid (19.05%). The combination of CBZ/PB was the most commonly observed, at 47.06%. Among patients taking carbamazepine, 2% were underdosed and 23% were overdosed. 75% of patients taking phenobarbital were underdosed. Half of patients taking valproic acid were underdosed and 5% were overdosed. Conclusion: Pharmacological therapeutic monitoring is an indispensable tool in the management of epilepsy. However, efforts must be made to introduce this practice into routine healthcare in Mali. Keywords: Therapeutic monitoring, Carbamazepine, Phenobarbital, Valproic acid, Mali