The Impact of Anti-Epileptic Drugs on Growth and Bone Metabolism.

Hueng-Chuen Fan, Herng-Shen Lee, Kai-Ping Chang, Yi-Yen Lee, Hsin-Chuan Lai, Pi-Lien Hung, Hsiu-Fen Lee, Ching-Shiang Chi

Journal: International journal of molecular sciences 2017;17(8):1242

PMID: 27490534

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Abstract

Epilepsy is a common neurological disorder worldwide and anti-epileptic drugs (AEDs) are always the first choice for treatment. However, more than 50% of patients with epilepsy who take AEDs have reported bone abnormalities. Cytochrome P450 (CYP450) isoenzymes are induced by AEDs, especially the classical AEDs, such as benzodiazepines (BZDs), carbamazepine (CBZ), phenytoin (PT), phenobarbital (PB), and valproic acid (VPA). The induction of CYP450 isoenzymes may cause vitamin D deficiency, hypocalcemia, increased fracture risks, and altered bone turnover, leading to impaired bone mineral density (BMD). Newer AEDs, such as levetiracetam (LEV), oxcarbazepine (OXC), lamotrigine (LTG), topiramate (TPM), gabapentin (GP), and vigabatrin (VB) have broader spectra, and are safer and better tolerated than the classical AEDs. The effects of AEDs on bone health are controversial. This review focuses on the impact of AEDs on growth and bone metabolism and emphasizes the need for caution and timely withdrawal of these medications to avoid serious disabilities.

Address: Department of Pediatrics, Tungs' Taichung Metroharbor Hospital, Wuchi, 435 Taichung, Taiwan. [email protected].; Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, 356 Miaoli, Taiwan. [email protected].; Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, 813 Kaohsiung, Taiwan. [email protected].; Department of Pediatrics, Taipei Veterans General Hospital, 112 Taipei, Taiwan. [email protected].; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, 112 Taipei, Taiwan. [email protected].; Faculty of Medicine, National Yang-Ming University, 112 Taipei, Taiwan. [email protected].; Department of Pediatrics, Tungs' Taichung Metroharbor Hospital, Wuchi, 435 Taichung, Taiwan. [email protected].; Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, 356 Miaoli, Taiwan. [email protected].; Department of Pediatrics, Kaohsiung Chang Gung Medical Center, 833 Kaohsiung, Taiwan. [email protected].; Department of Pediatrics, Taichung Veterans General Hospital, 407 Taichung, Taiwan. [email protected].; Department of Pediatrics, Tungs' Taichung Metroharbor Hospital, Wuchi, 435 Taichung, Taiwan. [email protected].; Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, 356 Miaoli, Taiwan. [email protected].

DOI: 10.3390/ijms17081242

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MeSH Terms: Anticonvulsants, Bone Density, Humans, Osteogenesis