Bone disease associated with antiepileptics use: is it screened by neurologists?
PDF (Español)

Keywords

anticonvulsants
osteoporosis
neurology
bone

Abstract

OBJETIVO: osteoporosis is classified by the World Health Organization as one of the main civilization diseases. It is characterized by low bone mass and its importance is continuously increasing. Some antiepileptic drugs have been shown to be associated with decreased bone mineral density. However, quoted studies show poor neurologists’ vigilance regarding the possibility of skeletal disorders in their patients taking antiepileptic drugs.

MATERIAL AND METHODS: a self administered survey was designed to determine the approaches of neurologists to screen for osteoporosis. An analysis of these results is presented as the review of the literature related to bone health in epileptic treated patients.

RESULTS: most of the neurologists do not consider bone disease of main clinical importance.

PDF (Español)

References

Tomita S, Ohnishi JI, Nakano M, et al. The effects of anticonvulsant drugs on vitamin D3-activating cytochrome p-450-linked monooxygenase systems. J Steroid Biochem Mol Biol 1991;39:479-85.

Lado F, Spiegel R, Masur JH, et al. Value of routine screening for bone demineralization in an urban population of patients with epilepsy. Epilepsy Res 2008;78:155-160.

Adams RD, Victor M, Ropper AH. Principles of Neurology 8th ed. New York,NY: Mc Graw Hill Co;2005. p:295.

Engel, J. Jr. and Pedley, T.A. (Eds.), Epilepsy: A Comprehensive Textbook. Vols. 1, 2 and 3. Philadelphia, Lippincott-Raven Publishers, 1997: 2976.

Kasper DL., Fauci AS, Longo DL, et al. Harrison’s Principles of Internal Medicine. 16th edition. McGraw-Hill, 2005.

http://www.aesnet.org/

Sahota O, Masud T, San P, et al. Vitamin D insufficiency increases bone turnover markers and enhances bone loss at the hip in patients with established vertebral osteoporosis. Clin Endocrinol 1999;51:217-21.

Heller HJ, Sakhaee K. Anticonvulsant-induced bone disease: a plea for monitoring and treatment. Arch Neurol 2001;58:1352-3.

Valmadrid C, Voorhees C, Litt B, et al. Practice patterns of neurologists regarding bone and mineral effects of antiepileptic drug therapy. Arch Neurol 2001;58:1369-74.

Bâlter KA, Bàlter O, Fondell E, et al. Web-based and mailed questionnaires: a comparison of response rates and compliance. Epidemiology 2005;16:577-9.

Pack AM, Gidal B, Vazquez B. Bone disease associated with antiepileptic drugs. Cleve Clin J Med 2004;71(Suppl 2):S42-8.

Dent CE, Richens A, Rowe DJ, et al. Osteomalacia with long-term anticonvulsant therapy in epilepsy. Br Med J 1970;4:69-72

El-Hajj Fuleihan G, Dib L, Yamout B, et al. Predictors of bone density in ambulatory patients on antiepileptic drugs. Bone 2008;43:149-55.

Samaniego EA, Sheth RD. Bone consequences of epilepsy and antiepileptic medications. Semin Pediatr Neurol 2007;14:196-200.

Stephen LJ, McLellan AR, Harrison JH, et al. Bone density and antiepileptic drugs: a case-controlled study. Seizure 1999;8:339-42.

Sheth RD, Hermann BP. Bone mineral density with lamotrigine monotherapy for epilepsy. Pediatr Neurol 2007;37:250-4.

Sheth RD, Binkley N, Hermann BP. Progressive bone deficit in epilepsy. Neurology 2008;70:170-176.

Öner N, Kaya M, Karasalihoglu S, et al. Bone mineral metabolism changes in epileptic children receiving valproic acid. J Paediatr Child Health 2004;40:470-473.

Tsukahara H, Kimura K, Todoroki Y, et al. Bone mineral status in ambulatory pediatric patients on long-term antiepileptic drugs. Pediatr Int 2002;44:247-253.

Sato Y, Kondo I, Ishida S, et al. Decreased bone mass and increased bone turnover with valproate therapy in adults with epilepsy. Neurology 2001;57:445-449.

Boluk A, Guzelipek M, Savli H, et al. The effect of valproate on bone mineral density in adult epileptic patienrs. Pharmacol Res 2004;50:93-97.

Petty SJ Paton LM, O´Brien TJ, et al. Effect of antiepileptic medication on bone mineral measures. Neurology 2005;65:1358-1365.

Ensrud KE, Walczak TS, Blackwell T, et al. Antiepileptic drug use increases rates of bone loss in older women: a prospective study. Neurology 2004;6:2051-2057.

Farhat G, Yamout B, Mikati MA, et al. Effect of antiepileptic drugs on bone density in ambulatory patients. Neurology 2002;58:1348-53.

Kafali G, Erselcan T, Tanzer F. Effect of antiepileptic drugs on bone mineral density in children between ages 6 and 12 years. Clin Pediatr (Phila) 1999;38:93-8.

Sheth RD, Wesolowski CA, Jacob JC, et al. Effect of carbamazepine and valproate on bone mineral density. J Pediatr 1995;127:256-62.

Pack AM, Morrell MJ, Randall A, et al. Bone health in young women with epilepsy after one year of antiepileptic drug monotherapy. Neurology 2008;70:1586-1593.

Pack A. Bone health in people with epilepsy: is it impaired and what are the risk factors? Seizure 2008;17:181-186.

Karceski SC. Bone health. Neurology 2008; 70:e71.

Petty SJ, O´Brien TJ, Wark JD. Anti-epileptic medication and bone health. Osteoporos Int 2007; 18:129-142.

Pack AM. The association between antiepileptic drugs and bone disease. Epilepsy Curr 2003;3:91-95.

Sheth RD, Hermann BP. Bone in idiopathic and symptomatic epilepsy. Epilepsy Res 2008;78(1):71-6.

Ebeling PR. Osteoporosis in men. N Engl J Med 2008;358:1474-1482.

Pack AM, Morrell MJ. Adverse effects of antiepileptic drugs on bone structure: epidemiology, mechanisms and therapeutic implications. CNS Drugs 2001;15:633-642.

Drezner MK. Treatment of anticonvulsant drug- induced bone disease. Epilepsy Behav 2004;5:S41-S47.

Carter ND, Khan KM. McKay HA, et al. Community- based exercise program reduces risk factors for falls in 65- to 75-year-old women with osteoporosis: randomized controlled. CMAJ 2002; 167:997-1004.

Mundy GR. Osteoporosis: pathophysiology and non- pharmacological management. Best Pract Res Clin Rheumatol 2001;15 :727-745.

Torgerson DJ, Bell-Syer SE. Hormone replacement therapy and prevention of vertebral fractures: a meta-analysis of randomized trials. JAMA 2001;285:2891-2897.

Spencer DC, Karceski S. About bone health. Neurology 2008; 70:e72-e73.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Downloads

Download data is not yet available.