title: Bone and calcium metabolism and antiepileptic drugs.
abstract: There is increasing evidence suggesting that epilepsy and its treatment can affect bone mineralization and calcium metabolism. Many studies have shown a significant reduction in bone mineral density in patients treated with classic (phenobarbital, carbamazepine, valproate, etc.) and with new (oxcarbazepine, gabapentin) antiepileptic drugs. In spite of data about the possible effects of the antiepileptic drugs on calcium metabolism, the mechanisms of this important side effect remain to be defined. The abnormalities of calcium metabolism were thought to result from the cytochrome P450 enzyme-inducing properties of some antiepileptic drugs and the resultant reduction in vitamin D levels, but the effect of many medications (e.g., valproate) cannot be readily explained by vitamin D metabolism. In this article, the literature related to the effects of classic and new antiepileptic drugs on bone health and calcium metabolism is reviewed.
authors.affiliation: Department of Pediatrics, University of Chieti, Italy. averrott@unich.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Verrotti
authors.forename: Giangennaro
authors.initials: G
authors.lastname: Coppola
authors.forename: Pasquale
authors.initials: P
authors.lastname: Parisi
authors.forename: Angelika
authors.initials: A
authors.lastname: Mohn
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiarelli
mesh_terms: D000818:Animals; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism*; D002118:Calcium / Q000378:metabolism*; D004827:Epilepsy / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D014807:Vitamin D / Q000378:metabolism
chemical_list: D000927:Anticonvulsants; D014807:Vitamin D; D002118:Calcium