title: Carbamazepine affects autonomic cardiac control in patients with newly diagnosed epilepsy.
abstract: Previous studies indicate that epilepsy patients may have impaired autonomic cardiovascular control in the interictal state although it is unclear whether the observed reduction in cardiovascular responses is due to the epilepsy and the interictal epileptogenic discharges, or to the treatment with antiepileptic drugs. Spectral analysis of heart rate variability makes it possible to partly separate the sympathetic components, low frequency (LF), from the vagal components, high frequency (HF) of autonomic cardiac control. We used spectral analysis of heart rate variability to assess the effect of carbamazepine (CBZ) on autonomic cardiac control in patients with newly diagnosed epilepsy. Fifteen adult outpatients with newly diagnosed seizures/epilepsy underwent 24 h ambulatory EKG recordings before and after commencement of CBZ treatment. Total power as well as low frequency (LF), very low frequency (VLF) and high frequency (HF) power in heart rate variability was calculated. When analysing the full 24 h recordings, patients had significantly lower standard deviation of RR-intervals (P=0.0015), total power (P=0.0010), LF (P=0.0002), VLF (P=0.0025) and HF (P=0.0139) during treatment with CBZ than before. The results were very similar for daytime and night time recordings. Our observations demonstrate that CBZ may suppress both parasympathetic and sympathetic functions in newly diagnosed patients with epilepsy. The possible implications of our results for sudden unexpected death in epilepsy are discussed.
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institute at Department of Neurology, R3:04 Karolinska Hospital, Stockholm SE-171 76, Sweden. hakan.persson@ks.se
authors.forename: Håkan
authors.initials: H
authors.lastname: Persson
authors.forename: Mats
authors.initials: M
authors.lastname: Ericson
authors.forename: Torbjörn
authors.initials: T
authors.lastname: Tomson
mesh_terms: D000328:Adult; D000368:Aged; D001341:Autonomic Nervous System / Q000187:drug effects* / Q000502:physiology; D002220:Carbamazepine / Q000494:pharmacology* / Q000627:therapeutic use*; D002319:Cardiovascular System / Q000187:drug effects; D004827:Epilepsy / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D002220:Carbamazepine