title: Favorable change of lipid profile after carbamazepine withdrawal.
abstract: OBJECTIVE
  Patients treated with carbamazepine (CBZ) have increased serum levels of total cholesterol (TC), high-density lipoproteins (HDL), and low-density lipoproteins (LDL). We aimed to investigate whether these changes of serum lipids are reversible after CBZ withdrawal.
  
  
  METHODS
  We used a prospective, randomized double-blinded design. A total of 160 patients who had been seizure free on anti-epileptic drug monotherapy for more than 2 years were included and randomized to withdrawal or not. The intervention was completed by 150 (80 females, 53%) patients. Serum samples from before and 4 months after completed withdrawal or no withdrawal were obtained from 130 patients (63 females, 48%). Of these, 84 were treated with CBZ, 28 with valproate, nine with phenytoin, four with phenobarbital, and five with lamotrigine. Of the patients who had been treated with CBZ, 47 were randomized to the withdrawal group, and 37 were randomized to the non-withdrawal group.
  
  
  RESULTS
  Among the CBZ-treated patients, a significant decrease in serum levels of TC, LDL, and apolipoprotein B (ApoB) were found in the withdrawal group compared with the non-withdrawal group. Mean differences in change were as follows: TC 0.68 mmol/l (P = 0.005, CL - 1.15 to -0.21); LDL - 0.67 mmol/l (P = 0.001, CL - 1.03 to -0.29); ApoB - 0.13 g/l (P = 0.02, CL - 0.23 to -0.03). No significant changes in HDL, apolipoprotein A, and C-reactive protein were detected.
  
  
  CONCLUSIONS
  Our results indicate that CBZ may have unfavorable effects on serum levels of TC, LDL, and ApoB. However, these changes seem to be reversible even after years of treatment.
authors.affiliation: National Centre for Epilepsy, Division of Surgery and Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.
authors.forename: M I
authors.initials: MI
authors.lastname: Lossius
authors.affiliation: National Centre for Epilepsy, Division of Surgery and Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.
authors.forename: K O
authors.initials: KO
authors.lastname: Nakken
authors.affiliation: Department of Paediatrics, Division Woman and Child, Oslo University Hospital, Oslo, Norway.
authors.forename: P
authors.initials: P
authors.lastname: Mowinckel
authors.affiliation: Department of Neurology, Division of Surgery and Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Taubøll
authors.affiliation: Department of Neurology, Division of Surgery and Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.|Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: L
authors.initials: L
authors.lastname: Gjerstad
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects*; D001055:Apolipoproteins B / Q000097:blood*; D002220:Carbamazepine / Q000009:adverse effects*; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D004311:Double-Blind Method; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D001055:Apolipoproteins B; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D010446:Peptide Fragments; C093007:apolipoprotein B (3304-3317); D002220:Carbamazepine; D002784:Cholesterol
keywords: adverse effects; anti-epileptic drugs; epilepsy