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Adverse effects of antiepileptic drugs on bone mineral density

Arzu Babayigit1, Eray Dirik, Ece Bober

  • 1Department of Pediatrics, Division of Neurology, Dokuz Eylul University Medical Faculty, Izmir, Turkey. arbabyigit@yahoo.com

Pediatric Neurology
|August 31, 2006
PubMed

Insights

Long-term use of antiepileptic drugs like valproic acid, carbamazepine, and oxcarbazepine in children with epilepsy is linked to lower bone mineral density. These medications may affect bone metabolism, warranting further investigation.

Area of Science:

  • Pediatric Endocrinology
  • Neurology
  • Pharmacology

Background:

  • Epilepsy is a common neurological disorder in children.
  • Antiepileptic drugs (AEDs) such as valproic acid, carbamazepine, and oxcarbazepine are standard treatments for epilepsy.
  • Concerns exist regarding the long-term effects of AEDs on bone health in pediatric populations.

Purpose of the Study:

  • To investigate the impact of valproic acid, carbamazepine, and oxcarbazepine on bone metabolism markers.
  • To assess bone mineral density (BMD) in children with idiopathic epilepsy on long-term AED treatment.
  • To compare biochemical bone markers and BMD between epileptic children on AEDs and healthy controls.

Main Methods:

  • Cross-sectional study involving 68 children with idiopathic epilepsy on AEDs (carbamazepine, valproic acid, or oxcarbazepine) for over 1 year and 30 healthy controls.
  • Blood samples analyzed for calcium, phosphorus, alkaline phosphatase, parathormone, and 25-hydroxyvitamin D.
  • Bone mineral density measured using dual-energy x-ray absorptiometry (DXA).

Main Results:

  • No significant differences in serum calcium, phosphorus, liver enzymes, or albumin between groups.
  • Elevated serum alkaline phosphatase levels observed in the AED-treated patient group compared to controls.
  • Significantly lower bone mineral density values in children receiving AEDs compared to healthy children.

Conclusions:

  • Long-term treatment with valproic acid, carbamazepine, or oxcarbazepine is associated with reduced bone mineral density in children.
  • AED therapy may negatively impact skeletal mineralization.
  • Further research is needed to elucidate the precise mechanisms and long-term skeletal consequences of these AEDs in pediatric epilepsy.

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