Shortcomings in the pharmacotherapy of epileptic children in Bombay, India.

In 108 epileptic children referred for Therapeutic Drug Monitoring (TDM), 60 (56 per cent) had epilepsy for over 2 years. At first estimation among 79 (73 per cent) children on monotherapy, only three out of 23 on phenytoin, 20 out of 31 on phenobarbitone, and 15 out of 25 on carbamazepine had plasma levels within the therapeutic range. After TDM, only nine (8 per cent) were advised to continue the original prescription. Only 35 (32 per cent) followed up beyond 6 months and 15 (14 per cent) who benefited had a significantly shorter duration of epilepsy before referral (P < 0.001). Eventually, 12 (11 per cent) followed up beyond 2 years, and five (5 per cent) had achieved a probable cure. The study highlights the urgent need for setting up TDM clinics for epileptic children in India.