title: Markers of bone turnover in patients with epilepsy and their relationship to management of bone diseases induced by antiepileptic drugs.
abstract: Data from cross-sectional and prospective studies revealed that patients with epilepsy and on long-term treatment with antiepileptic drugs (AEDs) are at increased risk for metabolic bone diseases. Bone diseases were reported in about 50% of patients on AEDs. Low bone mineral density, osteopenia/osteoporosis, osteomalacia, rickets, altered concentration of bone turnover markers and fractures were reported with phenobarbital, phenytoin, carbamazepine, valproate, oxcarbazepine and lamotrigine. The mechanisms for AEDs-induced bone diseases are heterogeneous and include hypovitaminosis D, hypocalcemia and direct acceleration of bone loss and/or reduction of bone formation. This article reviews the evidence, predictors and mechanisms of AEDs-induced bone abnormalities and its clinical implications. For patients on AEDs, regular monitoring of bone health is recommended. Prophylactic administration of calcium and vitamin D is recommended for all patients. Treatment doses of calcium and vitamin D and even anti-resorptive drug therapy are reserved for patients at high risk of pathological fracture.
authors.affiliation: a Department of Neurology and Psychiatry , Assiut University Hospital , Assiut , Egypt.
authors.forename: Sherifa A
authors.initials: SA
authors.lastname: Hamed
mesh_terms: D000818:Animals; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000378:metabolism; D015519:Bone Density / Q000187:drug effects; D001847:Bone Diseases / Q000139:chemically induced* / Q000473:pathology / Q000517:prevention & control; D002118:Calcium / Q000008:administration & dosage; D004827:Epilepsy / Q000188:drug therapy*; D006801:Humans; D014807:Vitamin D / Q000008:administration & dosage
chemical_list: D000927:Anticonvulsants; D015415:Biomarkers; D014807:Vitamin D; D002118:Calcium
keywords: Antiepileptic drugs; bone metabolism; bone mineral density; bone turnover markers; osteoporosis