title: Reduced immunoglobulin levels in epilepsy patients treated with levetiracetam, lamotrigine, or carbamazepine.
abstract: OBJECTIVE
  The aim of the study was to investigate immunoglobulin levels in patients with epilepsy using the antiepileptic drugs (AED) levetiracetam (LEV), carbamazepine (CBZ), or lamotrigine (LTG).
  
  
  METHODS
  A total of 211 patients and 80 controls (age: 18-45 years) of both genders were included. The patients had been treated with either LEV (n = 47), CBZ (n = 90), or LTG (n = 74) monotherapy for at least 6 months. Total concentrations of immunoglobulin G (IgG), IgG subclasses (IgG1, IgG2, IgG3, and IgG4), immunoglobulin A (IgA), and immunoglobulin M (IgM) were measured. Smoking, drinking habits, and physical activity were recorded, and body mass index (BMI) was calculated.
  
  
  RESULTS
  A significantly lower total IgG and IgG1 was found in both men and women treated with LTG and in men on CBZ. IgG2 and IgG4 were also lower in LTG-treated women, and IgA and IgM were lower in LTG-treated men. Patients treated with LEV did not differ from the control group.
  
  
  CONCLUSIONS
  Low levels of immunoglobulins were found in patients with epilepsy treated with LTG or CBZ. As our group of patients consisted of otherwise healthy young adults, one should be especially aware of a possible effect of AEDs on immunoglobulin levels when treating selected patient groups, for example immunocompromised patients. Immunoglobulin concentrations should be measured in patients treated with LTG or CBZ who experience recurrent infections, and a change in medication should be considered.
authors.affiliation: Department of Neurology, Oslo University Hospital - Rikshospitalet, Oslo, Norway. sigrid.svalheim@rikshospitalet.no
authors.forename: S
authors.initials: S
authors.lastname: Svalheim
authors.forename: U
authors.initials: U
authors.lastname: Mushtaq
authors.forename: M
authors.initials: M
authors.lastname: Mochol
authors.forename: G
authors.initials: G
authors.lastname: Luef
authors.forename: M
authors.initials: M
authors.lastname: Rauchenzauner
authors.forename: S S
authors.initials: SS
authors.lastname: Frøland
authors.forename: E
authors.initials: E
authors.lastname: Taubøll
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D015992:Body Mass Index; D002220:Carbamazepine / Q000627:therapeutic use; D004311:Double-Blind Method; D004827:Epilepsy / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood* / Q000145:classification; D000077213:Lamotrigine; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D010889:Piracetam / Q000031:analogs & derivatives / Q000627:therapeutic use; D018709:Statistics, Nonparametric; D014227:Triazines / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D007136:Immunoglobulins; D014227:Triazines; D002220:Carbamazepine; D000077287:Levetiracetam; D000077213:Lamotrigine; D010889:Piracetam