Antiepileptic Drugs and Bone Health: Current Concepts

Overview

Journal Psychopharmacol Bull

Specialty Pharmacology

Date 2020 Jun 9

PMID 32508365

Citations 7

Authors

Antonio Siniscalchi

Sean Murphy

Erika Cione

Leonardo Piro

Giovambattista De Sarro

Luca Gallelli

Affiliations

Soon will be listed here.

Abstract

Chronic use of antiepileptic drugs (AEDs) can induce the development of adverse effects on bone metabolism. In epileptic patients treated with AED, the monitoring of biochemical markers of bone turnover, such as the measurement of serum 25 (OH) vitamin D, bone mineral density, before the beginning of the treatment and during the follow-up is not routinely required. In the future, monitoring of biochemical markers in epileptic patients treated with AED may help us for adequate prevention therapy.

Citing Articles

Do tribal community children show varied antiepileptic response?.

Velmurugan H, Neelambaran K, Thangaraju P J Family Med Prim Care. 2024; 13(4):1574-1575.

PMID: 38827729 PMC: 11141964. DOI: 10.4103/jfmpc.jfmpc_1671_23.

Phenytoin is associated with increased risk of osteoporosis and fragility fractures in adult epileptic patients.

DeShazo S, Ozmer G, Horton K, Weiss W J Bone Miner Metab. 2023; 42(1):69-76.

PMID: 38060024 DOI: 10.1007/s00774-023-01475-2.

Vitamin D and Calcium in Osteoporosis, and the Role of Bone Turnover Markers: A Narrative Review of Recent Data from RCTs.

Voulgaridou G, Papadopoulou S, Detopoulou P, Tsoumana D, Giaginis C, Kondyli F Diseases. 2023; 11(1).

PMID: 36810543 PMC: 9944083. DOI: 10.3390/diseases11010029.

Osteogenic Effect of Pregabalin in Human Primary Mesenchymal Stem Cells, Osteoblasts, and Osteosarcoma Cells.

Wagener N, Di Fazio P, Boker K, Matziolis G Life (Basel). 2022; 12(4).

PMID: 35454987 PMC: 9032037. DOI: 10.3390/life12040496.

Significant Association of Antiepileptic Drug Polytherapy with Decreased FT4 Levels in Epileptic Patients.

Dabla P, Sharma S, Mir R, Puri V Indian J Clin Biochem. 2022; 37(1):107-112.

PMID: 35125700 PMC: 8799786. DOI: 10.1007/s12291-020-00946-x.

References

Petty S, Milligan C, Todaro M, Richards K, Kularathna P, Pagel C . The antiepileptic medications carbamazepine and phenytoin inhibit native sodium currents in murine osteoblasts. Epilepsia. 2016; 57(9):1398-405. DOI: 10.1111/epi.13474. View

Jette N, Lix L, Metge C, Prior H, McChesney J, Leslie W . Association of antiepileptic drugs with nontraumatic fractures: a population-based analysis. Arch Neurol. 2011; 68(1):107-12. DOI: 10.1001/archneurol.2010.341. View

Nakken K, Tauboll E . Bone loss associated with use of antiepileptic drugs. Expert Opin Drug Saf. 2010; 9(4):561-71. DOI: 10.1517/14740331003636475. View

Guo C, Ronen G, Atkinson S . Long-term valproate and lamotrigine treatment may be a marker for reduced growth and bone mass in children with epilepsy. Epilepsia. 2001; 42(9):1141-7. DOI: 10.1046/j.1528-1157.2001.416800.x. View

Krishnamoorthy G, Karande S, Ahire N, Mathew L, Kulkarni M . Bone metabolism alteration on antiepileptic drug therapy. Indian J Pediatr. 2009; 76(4):377-83. DOI: 10.1007/s12098-009-0005-5. View

Verrotti A, Coppola G, Parisi P, Mohn A, Chiarelli F . Bone and calcium metabolism and antiepileptic drugs. Clin Neurol Neurosurg. 2009; 112(1):1-10. DOI: 10.1016/j.clineuro.2009.10.011. View

Zhang Y, Zheng Y, Zhu J, Zhang J, Zheng Z . Effects of antiepileptic drugs on bone mineral density and bone metabolism in children: a meta-analysis. J Zhejiang Univ Sci B. 2015; 16(7):611-21. PMC: 4506952. DOI: 10.1631/jzus.B1500021. View

Ensrud K, Walczak T, Blackwell T, Ensrud E, Bowman P, Stone K . Antiepileptic drug use increases rates of bone loss in older women: a prospective study. Neurology. 2004; 62(11):2051-7. DOI: 10.1212/01.wnl.0000125185.74276.d2. View

Tosun A, Erisen Karaca S, Unuvar T, Yurekli Y, Yenisey C, Kurt Omurlu I . Bone mineral density and vitamin D status in children with epilepsy, cerebral palsy, and cerebral palsy with epilepsy. Childs Nerv Syst. 2016; 33(1):153-158. DOI: 10.1007/s00381-016-3258-0. View

10.

He X, Jiang P, Zhu W, Xue Y, Li H, Dang R . Effect of Antiepileptic Therapy on Serum 25(OH)D3 and 24,25(OH)2D3 Levels in Epileptic Children. Ann Nutr Metab. 2016; 68(2):119-27. DOI: 10.1159/000443535. View

11.

Siniscalchi A, Gallelli L, Russo E, De Sarro G . A review on antiepileptic drugs-dependent fatigue: pathophysiological mechanisms and incidence. Eur J Pharmacol. 2013; 718(1-3):10-6. DOI: 10.1016/j.ejphar.2013.09.013. View

12.

Albaghdadi O, Alhalabi M, Alourfi Z, Youssef L . Bone health and vitamin D status in young epilepsy patients on valproate monotherapy. Clin Neurol Neurosurg. 2016; 146:52-6. DOI: 10.1016/j.clineuro.2016.04.019. View

13.

Shiek Ahmad B, Petty S, Gorelik A, OBrien T, Hill K, Christie J . Bone loss with antiepileptic drug therapy: a twin and sibling study. Osteoporos Int. 2017; 28(9):2591-2600. DOI: 10.1007/s00198-017-4098-9. View

14.

Ensrud K, Walczak T, Blackwell T, Ensrud E, Barrett-Connor E, Orwoll E . Antiepileptic drug use and rates of hip bone loss in older men: a prospective study. Neurology. 2008; 71(10):723-30. PMC: 2676952. DOI: 10.1212/01.wnl.0000324919.86696.a9. View

15.

Wilson E, Garton M, Fuller H . Anti-epileptic drugs and bone loss: Phenytoin reduces pro-collagen I and alters the electrophoretic mobility of osteonectin in cultured bone cells. Epilepsy Res. 2016; 122:97-101. DOI: 10.1016/j.eplepsyres.2016.03.002. View

16.

Siniscalchi A . [Hyperhomocysteinemia in neurologic diseases]. Recenti Prog Med. 2004; 95(7-8):371-5. View

17.

Fernandez H, Cooke M, Patel T . Epilepsy and lifestyle behaviors related to bone health. Epilepsia. 2019; 60(11):2306-2313. DOI: 10.1111/epi.16351. View

18.

Carbone L, Johnson K, Robbins J, Larson J, Curb J, Watson K . Antiepileptic drug use, falls, fractures, and BMD in postmenopausal women: findings from the women's health initiative (WHI). J Bone Miner Res. 2009; 25(4):873-81. PMC: 3153335. DOI: 10.1359/jbmr.091027. View

19.

Farhat G, Yamout B, Mikati M, Demirjian S, Sawaya R, El-Hajj Fuleihan G . Effect of antiepileptic drugs on bone density in ambulatory patients. Neurology. 2002; 58(9):1348-53. DOI: 10.1212/wnl.58.9.1348. View

20.

Ahmad B, OBrien T, Gorelik A, Hill K, Wark J . Bone Mineral Changes in Epilepsy Patients During Initial Years of Antiepileptic Drug Therapy. J Clin Densitom. 2016; 19(4):450-456. DOI: 10.1016/j.jocd.2016.07.008. View