Effect of Chronic Anticonvulsant Therapy on Serum 25-Hydroxycalciferol Levels in Adults

Hahn, Theodore J.; Hendin, Barry; Scharp, Cheryl R.; Haddad, John G.

doi:10.1056/nejm197211022871803

Cited by 337 publications

(136 citation statements)

References 15 publications

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“…Richens & Rowe 5 measured the serum levels of alkaline phosphatase isoenzymes in chronic anticonvulsant users and found that the hepatic fraction was predominant (60%). This result was similar to the one obtained by Hahn et al 6 , which showed an increase in the hepatic isoenzyme in recent anticonvulsant users (up to six months). This increase in hepatic alkaline phosphatase serum, which may alter hepatic function, could be due to the chronic use of anticonvulsant medication 12 .…”

Section: Discussionsupporting

confidence: 92%

Section: Densidade Mineral óSsea Vitamina D E Terapia Anticonvulsivantementioning

confidence: 99%

“…Alterations in the metabolism of calcium are generally very slight and subclinical, but clear cases of hypocalcemia could occur in 4% to 30% of individuals. The intensity of the clinical symptoms depends on many factors, such as: intake of vitamin D, exposure to the sun, physical activity, other diseases that interfere in vitamin D metabolism, the positive correlation of these manifestations with the type of drug, individual drug dosage, and period of exposure, as well as polytherapy 3,6 .This study, which was conducted to assess bone mineral density and vitamin D metabolism in a sample of the Brazilian epileptic population on chronic anticonvulsant therapy, was motivated by the fact that the intensity of alterations of vitamin D metabolism and bone mass was related not only to the chronic use of anticonvulsants but also to other variables. These included the characteristics of the population, such as sunlight exposure.…”

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Bone mineral density, vitamin D and anticonvulsant therapy

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Guerreiro

Magna

et al. 2000

Arq. Neuro-Psiquiatr.

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-The aim of this study was to assess bone mineral density and vitamin D metabolism in patients on chronic anticonvulsant therapy. Methods: Sixty-nine men, outpatients on chronic anticonvulsant therapy, who had been treated for at least 5 years, were studied, comparing them to thirty healthy controls. Bone mineral density was measured as well as serum levels of calcium, ionized calcium, alkaline phosphatase, PTH, 25-hydroxycholecalciferol and 1,25-dihydroxycholecalciferol. Results: No differences in bone mineral density, serum levels of vitamin D and intact-PTH were observed between patients and controls. Bone mineral density was not associated with chronic anticonvulsant therapy. Conclusion: Those adult patients who were on chronic anticonvulsant therapy and who lived in low latitude regions had normal bone mineral density as well as vitamin D serum levels.KEY WORDS: vitamin D, calcium, anticonvulsant, bone mineral density. Densidade mineral óssea, vitamina D e terapia anticonvulsivanteRESUMO -O objetivo deste estudo foi avaliar a densidade mineral óssea e o metabolismo da vitamina D em usuários crônicos de anticonvulsivantes. Métodos: Foram estudados 69 pacientes ambulatoriais, masculinos, usuários crônicos de anticonvulsivantes por período mínimo de 5 anos e comparados a 30 controles normais. Foram efetuadas as medidas da densidade mineral óssea e dos níveis plasmáticos do cálcio, cálcio iônico, fosfatase alcalina, paratormônio, 25-hidroxi-colecalciferol e 1,25-di-hidroxi-colecalciferol. Resultados: Nenhuma diferença na densidade mineral óssea e nos níveis plasmáticos da vitamina D e paratormônio foram observadas entre os pacientes e os controles. A densidade mineral óssea não se mostrou associada ao uso crônico de anticonvulsivantes. Conclusões: Pacientes adultos, do sexo masculino, usuários crônicos de anticonvulsivantes, residentes em regiões ensolaradas, têm densidade mineral óssea e níveis plasmáticos de vitamina D normais. PALAVRAS-CHAVE: vitamina D, cálcio, anticonvulsivante, densidade mineral óssea.Alterations in calcium, vitamin D and bone tissue metabolism have been associated with the following drugs: phenobarbital, phenytoin, primidone and carbamazepine 1,2 . Alterations in the metabolism of calcium are generally very slight and subclinical, but clear cases of hypocalcemia could occur in 4% to 30% of individuals. The intensity of the clinical symptoms depends on many factors, such as: intake of vitamin D, exposure to the sun, physical activity, other diseases that interfere in vitamin D metabolism, the positive correlation of these manifestations with the type of drug, individual drug dosage, and period of exposure, as well as polytherapy 3,6 .This study, which was conducted to assess bone mineral density and vitamin D metabolism in a sample of the Brazilian epileptic population on chronic anticonvulsant therapy, was motivated by the fact that the intensity of alterations of vitamin D metabolism and bone mass was related not only to the chronic use of anticonvulsants but also to other vari...

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Section: Discussionsupporting

confidence: 92%

Section: Densidade Mineral óSsea Vitamina D E Terapia Anticonvulsivantementioning

confidence: 99%

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Bone mineral density, vitamin D and anticonvulsant therapy

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Magna

et al. 2000

Arq. Neuro-Psiquiatr.

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“…(Hahn et al 1972(Hahn et al , 1975aStamp et al 1972 (1973) reported that a patient treated with PB alone suffered from rickets after the PB and DPH combination therapy . Accordingly, the administration of PB and DPH must be responsible for the rickets in the epileptic children.…”

Section: Discussionmentioning

confidence: 99%