Metabolic bone disease in patients with epilepsy and the use of antiepileptic drugs – Insight from a Danish cross-sectional study

Baddoo, Daniel Roger; Mills, Alexander Andrew; Kullab, Randa B; Al-Mashat, Hassan; Andersen, Noémi Becser; Jørgensen, Niklas Rye; Diemar, Sarah Seberg

doi:10.1016/j.seizure.2021.01.008

Cited by 4 publications

(1 citation statement)

References 19 publications

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“…phenytoin and phenobarbital has been known for decades. In a large cross-sectional study, 52 EIASMs were associated with a 2.2 times greater likelihood of developing osteoporosis compared to NEIASMs. The likelihood of developing osteoporosis also increased with each additional ASM, such that polytherapy with three ASMs resulted in a 2.3 times odds ratio of osteoporosis compared to one ASM.…”

Section: Accepted Manuscriptmentioning

confidence: 96%

Long-Term Effects of Antiseizure Medications

LoPinto-Khoury

2022

Semin Neurol

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Most patients with epilepsy will benefit from seizure control with one of an array of chronic antiseizure medications. Knowledge of the potential long-term effects of these medications is critical to prevent adverse consequences on overall health. Antiseizure medications vary in their capacities to affect the brain and peripheral nerves, hormones, bone mineralization, cardiovascular risk, renal health, hepatic, hematological, and dermatological systems. Understanding of pathophysiology and population risk has evolved, although most of the data available are still on older generation antiseizure medications such as phenytoin, carbamazepine, and valproic acid. The enzyme-inducing properties of some antiseizure medications make their effects on cardiovascular risk and bone health detrimental. Few clear guidelines exist for monitoring long-term effects of medication therapy for epilepsy. When selecting an antiseizure medication, consideration should be given to the individual patient's risks of adverse consequences on other organ systems. During monitoring of patients on chronic therapy, screening tools such as metabolic panels and bone density measurements can help stratify risk and guide management.

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Section: Accepted Manuscriptmentioning

confidence: 96%