Clinical consequences of microsomal enzyme-induction by antiepileptic drugs

The evidence presented above clearly illustrates the importance of enzyme-induction as a cause of drug-induced disease and drug interactions in epileptic patients. Unfortunately, available information on most of the issues discussed is as yet incomplete. A large number of physiological processes are directly or indirectly influenced by enzyme-induction and many more metabolic derangements secondary to this condition are likely to be discovered in the near future. A few important aspects, such as the possible relationship between enzyme-induction, carcinogenesis and teratogenesis, which have not been mentioned in the present article, are likely to receive particular attention in the forthcoming years. Exposure to enzyme-inducing compounds is now widespread, particularly in the industrialized world. Although patients treated with anticonvulsant drugs will continue to provide an ideal model for the study of this phenomenon, an improved understanding of its pathophysiological implications should eventually result in beneficial applications extending far beyond the medical care of people with epilepsy.