One of my patient 23 years now, female, having a problem of cetamian-epilepsy from six years, not responding to various treatments initially, but from last 3 years, she is on carbamazepine 600mg twice a day and responded well. From last 15 DAYS again complaining of giddiness, mood upset, and similar complaints as before. I THOUGHT TO CHANGE THE MEDICATION, BUT I HAD INTUITION, WHY NOT TO CHECK THE CARBAMAZEPINE LEVEL IN BLOOD. I ORDERED, TOMY SURPRISE, IT TURNS OUT TO BE 0.00, TWICE, THE SAMPLE SENT TO AUTHENTIC LAB, THAT ALSO TURNED OUT LESS THAN 0.02.
I INQUIRED ABOUT THE GIRL, WHETHER SHE IS TAKING REGULARLY OR NOT, MOTHER SAID, SHE TAKES IN FRONT ME ALWAYS. WHAT CAN BE THE CAUSE OF IT, LESS BIOAVAILABLE DRUG, OR SUB-STANDARD PREPARATION? OR ANY OTHER?
