Turbulent Flow Liquid Chromatography-Tandem Mass Spectrometry Methods for Antiepileptic Drug Quantitation in Serum.

Epilepsy is characterized by abnormal electrical discharges in the brain that result in unprovoked seizures. Pharmacotherapy with antiepileptic drugs (AED) can help control the incidence of epileptic seizures. AED therapeutic regimens often need to be individually tailored. Therapeutic drug monitoring (TDM) of AED is required to optimize therapeutic efficacy and minimize the risk of any associated destructive toxicities. We describe a turbulent flow liquid chromatography-tandem mass spectrometry (TFC-MS/MS) method for the detection of seven different AED in human serum. TFC-MS/MS testing was performed using a TLX-2 online sample preparation liquid chromatography (SPLC) system coupled to an API 5500 Q-Trap tandem mass spectrometer. Quantification of 10,11-dihydro-10-hydroxycarbamazepine, lacosamide, lamotrigine, levetiracetam, rufinamide, topiramate, and zonisamide was, respectively, performed using calibration curves (2-60 μg/mL, R2  > 0.99) with precisions of <10%.