[Serum lipids. lipoproteins, and apolipoproteins in adult epileptics treated with carbamazepine, valproic acid, or phenytoin].
BACKGROUND
It is known that anticonvulsants are able to modify lipid profile; nevertheless the initial studies were performed in patients or polytherapy whereas later investigations were carried out mostly in children.


OBJECTIVE
To evaluate serum lipids, lipoproteins and apolipoproteins in adult epileptic patients on monotherapy.


METHODS
Total cholesterol, triglycerides, low- and high-density lipoprotein cholesterol (including the HDL2 and the HDL3 subfractions) and apolipoproteins A1 and B were measured in 120 epileptics patients treated with carbamazepine (n = 42), sodium valproate (n = 38) and phenytoin (n = 40) and compared with the values of 48 healthy subjects.


RESULTS
Most of the measured parameters were significantly higher in patients receiving carbamazepine or phenytoin; carbamazepine-treated subjects showed specifically an increase in HDL2 lipoprotein cholesterol, whereas phenytoin-treated subjects showed specifically an increase of triglycerides; all of the observed alterations, save the increase in HDL lipoprotein cholesterol and apolipoprotein A1, were significant in women but not in men. Carbamazepine nor phenytoin related changes showed any correlation with the dose or the plasma levels of the drugs. No relevant modifications of serum lipids were seen in patients who received sodium valproate.


CONCLUSIONS
The observed alterations in serum lipids were associated to the use of anticonvulsants with enzyme inducing activity and showed significant differences between both sexes.
Pita-Calandre
E
E
Instituto de Neurociencias, Universidad de Granada, España. epita@intersalud.es
Rodríguez-López
C M
CM
Cano
M D
MD
Peña-Bernal
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D001053:Apolipoproteins / Q000097:blood*; D002220:Carbamazepine / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D004789:Enzyme Activation / Q000187:drug effects; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000139:chemically induced*; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010672:Phenytoin / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D012727:Sex Characteristics; D014280:Triglycerides / Q000097:blood; D014635:Valproic Acid / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use
D000927:Anticonvulsants; D001053:Apolipoproteins; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D008055:Lipids; D008074:Lipoproteins; D014280:Triglycerides; D002220:Carbamazepine; D014635:Valproic Acid; D010672:Phenytoin; D002784:Cholesterol
Lípidos, lipoproteínas y apolipoproteínas séricas en epilépticos adultos tratados con carbamacepina, ácido valproico o fenitoína.