[Evaluation of changes in gamma-glutamyltransferase in chronic treatment with antiepileptic agents]

To know the intensity of liver enzyme induction during a treatment with anticonvulsant, the authors have measured gamma GT before and at the 7th, 30th, 60th days after a treatment by one of the 4 major anticonvulsant as phenobarbital, diphenylhydantoin, carbamazepine and sodium valproate. All alcoholic patients, and all the patients having a liver disease have been eliminated. The results show that diphenylhydantoin is the most important inductor of gamma GT with an elevation that can reach 312% of basal level, followed by phenobarbital, when sodium valproate and carbamazepine are the weakest inductors. More, induction by carbamazepine in women is more weak than in man. Age takes a place in intensity of induction with a major induction observed between 30 and 50 years old for phenobarbital, and above 50 years old for sodium valproate. These effects are not dependent of an hepatitis. The knowledge of the upper levels of gamma GT induction by anticonvulsant appear to us usefull for several reasons: carbamazepine and sodium valproate being the weakest inductors, they must be chosen in priority in women under contraceptive treatment. Any abnormal elevation of gamma GT need to look of an alcoholic intoxication, an hepatitis or a liver cancer.