Necessity of Routine Labotatory Monitoring for Hematological Finding and Liver Function of Antiepilepic Medications

In a prospective study of 59 epileptic patients receiving anticonvulsant drugs, the author evaluated routine screening for hematologic and liver toxicity. CBC, differential, platelets and liver function were obtained within 6 months after anticonvulsant medication.

During this time, the author evaluated the psychiatric symptoms and adverse effects of drugs. In laboratory monitoring, 5.1% of patients had minor abnormalities of blood studies(minimal below level of Hb, Hct, MCV) and 18.6% of patients had abnormalities of liver function(elevation of ALP, ALT & AST) necessitating rechecks. All were the same finding on repeat, but there were no clinical symptoms of hematological abnormalities and liver toxicity. In clinical monitoring, 62.7 of patients had psychiatric symptoms and the most common symptom was depression(15.3%). 71.2% of patients had minor adverse effects of anticonvulsants and the most common symptom was disturbance of school performance(18.6%).

Conclusively, severe toxic reaction was not in the patients with abnormal hematologic & liver function, but psychiatric symptoms and adverse effects of drugs were sufficiently evaluated from clinical observation. So, the author believes that clinical monitoring is more important than laboratory monitoring and routine blood & liver function is not necessary.