Effect of carbamazepine on the bone health of people with epilepsy: a systematic review and meta-analysis

Zhang, Xinyue; Zhong, Rui; Chen, Qingling; Li, Mengmeng; Lin, Weihong; Cui, Li

doi:10.1177/0300060520902608

Cited by 15 publications

(15 citation statements)

References 42 publications

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“…This mechanism is primary linked to the use of phenobarbital, phenytoin, and carbamazepine. Several studies report the osteopenic effects of carbamazepine on bone metabolism (15)(16)(17)(18). On the other hand, several authors did not observe negative effects of carbamazepine therapy on vitamin D levels or biochemical markers of bone turnover (19,20).…”

Section: Discussionmentioning

confidence: 99%

“…Meyer et al concluded that the molecule of lamotrigine shows good penetration into tumor tissues and therefore might be efficacious in brain tumor patients, and even, due to its excellent tolerability and auspicious safety profile, it might be considered as the first choice agent for treating seizures in these patients (22). Nevertheless, the unfavorable effects of LTG on bone, including bone loss, impaired growth in children, alterations in BMD, and elevated bone turnover markers, have been reported (16,23,24).…”

Section: Discussionmentioning

confidence: 99%

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Longterm Antiepileptic Therapy and Bone Health: Implications for Patients with Brain Tumors

Mehičević

Mahmutbegović

Omerhodžić

et al. 2021

ama

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Objective. The objective of our study was to investigate the effects of carbamazepine (CBZ) and lamotrigine (LTG) treatment on bone metabolism in epileptic patients.Patients and Methods. A cross-sectional study was performed on normal controls (N=30) and 100 patients with symptomatic epilepsy caused by a primary brain tumor, divided into two groups according to the treatment: LTG monotherapy group (N=50) and CBZ monotherapy group (N=50). For each participant serum levels of 25-OHD and osteocalcin (OCLN) were measured, and bone mineral density (BMD) was evaluated by the dual-energy X-ray absorptiometry method.Results. There was no statistically significant difference in the average values of vitamin D in serum between the CBZ and LTG groups (Vitamin D CBZ 17.03±}12.86 vs. Vitamin D LTG 17.97±}9.15; F=0.171, P=0.680). There was no statistically significant difference in the average values of OCLN between the CBZ and LTG groups (OCLN CBZ 26.06±}10.87 vs. OCLN LTG 27.87±}28.45; F=0.171, P=0.674). The BMD value was lower in both groups using antiepileptic agents compared to the controls, but when comparing the CBZ group to the LTG group, a statistically significant difference was only observed for the Z score (T-score CBZ: 0.08±} 1.38 vs. T-score LTG: 0.37±} 1.02; F=1.495, P=0.224; Z score CBZ: -0.05±}1.17 vs. Z. Score CBZ: 0.38±}0.96; F=4.069, P=0.046) (Table 3).Conclusion. The choice of antiepileptic agents for treating seizures in patients with brain tumors should be carefully evaluated in relation to their impact on bone health. These patients could benefit from supplementation and regular measurement of biochemical markers of bone turnover and BMD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Longterm Antiepileptic Therapy and Bone Health: Implications for Patients with Brain Tumors

Mehičević

Mahmutbegović

Omerhodžić

et al. 2021

ama

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“…The association between carbamazepine monotherapy and BMD was also investigated in this study, and it was found that the use of this medication significantly decreased BMD, while no effect on serum osteocalcin levels was found [ 397 ]. However, no significant difference in BMD was found when comparing carbamazepine users to controls in a systematic review and meta-analysis investigating the effect of carbamazepine on bone health [ 399 ]. Furthermore, a decrease in femoral neck BMD after 1 year of treatment with phenytoin [ 398 ] and a greater rate of bone loss determined by BMD in users of phenytoin compared to non-users of ACs [ 400 ] was reported in previous literature.…”

Section: Non-osteoporotic Medications Fracture Risk and Bmdmentioning

confidence: 99%

The Effects of Osteoporotic and Non-osteoporotic Medications on Fracture Risk and Bone Mineral Density

Burgh

Keyser

Zillikens

et al. 2021

Drugs

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“…Another issue that needs to be addressed in the long-term treatment is decreasing bone mineral density causing osteoporosis that can occur with several CYP P450-inducing antiepileptics, most frequently, however, with CBZ [ 107 ] inducing the metabolism of vitamin D [ 107 , 108 ]. Therefore, guidelines recommend prophylactic prescription of vitamin D [ 109 ] and regular checks of vitamin D levels as well as regular bone densitometry.…”

Section: Methodsmentioning

confidence: 99%

Efficacy of Carbamazepine and Its Derivatives in the Treatment of Bipolar Disorder

Grunze¹,

Amann

Grunze

2021

Medicina

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Background and Objectives: This review is dedicated to the use of carbamazepine and its derivatives oxcarbazepine and eslicarbazepine in bipolar disorder and their relative strengths in treating and preventing new depressive or manic episodes. This paper will discuss the evidence of their efficacy relative to the polarity of relapse from controlled acute and maintenance/relapse prevention studies in bipolar patients. Materials and Methods: A Medline search was conducted for controlled acute and maintenance studies with carbamazepine, oxcarbazepine, and eslicarbazepine in bipolar disorder. In addition, abstracts reporting on controlled studies with these medications from key conferences were taken into consideration. Results: Information was extracted from 84 articles on the acute and prophylactic efficacy of the medications under consideration. They all appear to have stronger efficacy in treating acute mania than depression, which also translates to better protection against manic than depressive relapses for carbamazepine. Still, there is a paucity of controlled acute studies on bipolar depression for all and, with the exception of carbamazepine, a lack of long-term monotherapy maintenance data. For eslicarbazepine, the efficacy in bipolar disorder remains largely unknown. Especially with carbamazepine, tolerability issues and drug–drug interactions need to be kept in mind. Conclusions: Two of the medications discussed in this review, carbamazepine and oxcarbazepine, match Class A criteria according to the criteria proposed by Ketter and Calabrese, meaning acute antimanic efficacy, prevention of manic relapses, and not causing or worsening depression.

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Effect of carbamazepine on the bone health of people with epilepsy: a systematic review and meta-analysis

Cited by 15 publications

References 42 publications

Longterm Antiepileptic Therapy and Bone Health: Implications for Patients with Brain Tumors

Longterm Antiepileptic Therapy and Bone Health: Implications for Patients with Brain Tumors

The Effects of Osteoporotic and Non-osteoporotic Medications on Fracture Risk and Bone Mineral Density

Efficacy of Carbamazepine and Its Derivatives in the Treatment of Bipolar Disorder

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