Impact of Oxidative Stress and Newer Antiepileptic Drugs on the Albumin and Cortisol Value in Severe Motor and Intellectual Disabilities With Epilepsy

Abstract

BackgroundEpilepsy is a common complication in patients with severe motor and intellectual disabilities (SMID). There are no reports as yet of the effects of these medications in vivo other than their epileptic efficacy. The purpose of this study was to clarify the effects of the newer antiepileptic drugs (AEDs) on the blood biochemical parameters and oxidative stress in SMID with epilepsy by comparing the therapeutic effects between a group of patients receiving lamotrigine (LTG) and levetiracetam (LEV) in addition to the conventional AEDs (newer AED group) and a group receiving conventional AEDs alone (old AED group).MethodsThe study population consisted of 44 SMID patients with epilepsy, of which 23 were allocated to the newer AED group and 21 were allocated to the old AED group. In the newer AED group, measurements of the reactive oxygen metabolites (d-ROMs), biological antioxidant potential (BAP) and serum albumin were carried out at the following two time points: 1 week before and 1 year after the start of administration of the newer AEDs. In the old AED group, measurements of the same variables were performed at two time points 1 year apart.ResultsA significant decrease of the d-ROM levels and a significant increase of the BAP were noted in the newer AED group. A significant elevation of the serum albumin was also evident. In the old AED group, a significant increase of the d-ROMs levels was noted at the second measurement. Cortisol levels which have been described to be related to the albumin, revealed a significant decrease of the serum cortisol in relation to elevation of serum albumin in the newer AED group.ConclusionsThe present study results suggest that the addition of newer AEDs reduces the oxidative stress load and improves the antioxidant potential of the body. Furthermore, the present data also demonstrate that the newer AEDs have indirect impact on biological parameters.

Phenytoin–levetiracetam adjunctive treatment-induced neurotoxicity and deregulation of cholinergic neurotransmission with evidence of neurocognitive impairment in male Wistar rats

“…Significant increase in the accumulation of end product of lipid peroxidation, malondialdehyde following PHT, LEV, and PHT + LEV treatment is suggestive of the oxidative stress impact of the drugs either as a single or adjunctive treatment, but the LEV treatment was better tolerated. This present finding corroborates the previous report of Morimoto et al [43] and Mahmoud et al [44] that lipid membrane peroxidation in epilepsy treatment is not unrelated to the antiepileptic drugs. However, our finding is in contrast to the report of Menon et al [45] that oxidative stress in patients with epilepsy is independent of antiepileptic drugs.…”

The Neuroprotective Effects of Thymoquinone: A Review

“…An impairment of consciousness is found in generalized seizures and in the so-called complex focal seizures. 67 Status epilepticus is a type of seizures that last too long and the patient does not recover between seizures. It is indicated that oxidative stress plays a main role in the pathogenesis of SE.…”

Dexamethasone Suppression Test May Predict More Severe/Violent Suicidal Behavior

“…In the case of significant relationships, regression models were used after adjusting for sociodemographic and clinical variables that were significantly correlated with cortisol measures. Moreover, analyses were always adjusted for mood stabilizer intake, because previous studies showed that mood stabilizers are a confounder for cortisol (40,41).…”