Study of Antiepileptic Drugs effects on bone metabolism
Abstract
Background: There are numerous reports about the adverse effects of antiepileptic drugs (AED) on bone metabolism. This study was designed to evaluate these effects in children and adolescents.
Methods: We compared bone metabolism in children and adolescences 4-15 years old who were treated for 6 month with AED compare with a control group at the same age. Bone metabolism was evaluated by measurement of serum calcium, phosphorus, alkaline phosphates (ALP) and parathormone (PTH) in both group.
Findings: 119 patients and 119 controls were studied during a 20 months period. Normal serum calcium and phosphorus levels were observed in 96.6% and 93.3% of cases respectively. Serum alkaline phosphatase was normal in 76.5% of patients while raised levels were observed in the remaining 23.5%. PTH was normal in 77.3% of patients and increased in 18.5 % of cases. Serum ALP and PTH level were significantly higher than control group (P=0.00). Highest ALP and PTH levels were seen in carbamazepine consumers while patients on sodium valproate showed the least rise.
Conclusions: Periodic measurements of calcium, phosphorus, ALP, and specially PTH is recommended for the evaluation of bone metabolism in long-term treatment with AED, including sodium valproate.
Methods: We compared bone metabolism in children and adolescences 4-15 years old who were treated for 6 month with AED compare with a control group at the same age. Bone metabolism was evaluated by measurement of serum calcium, phosphorus, alkaline phosphates (ALP) and parathormone (PTH) in both group.
Findings: 119 patients and 119 controls were studied during a 20 months period. Normal serum calcium and phosphorus levels were observed in 96.6% and 93.3% of cases respectively. Serum alkaline phosphatase was normal in 76.5% of patients while raised levels were observed in the remaining 23.5%. PTH was normal in 77.3% of patients and increased in 18.5 % of cases. Serum ALP and PTH level were significantly higher than control group (P=0.00). Highest ALP and PTH levels were seen in carbamazepine consumers while patients on sodium valproate showed the least rise.
Conclusions: Periodic measurements of calcium, phosphorus, ALP, and specially PTH is recommended for the evaluation of bone metabolism in long-term treatment with AED, including sodium valproate.
Keywords
Bone metabolism, Alkaline phosphates,
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