title: Comparison of body composition in persons with epilepsy on conventional & new antiepileptic drugs.
abstract: OBJECTIVE
  Certain antiepileptic drugs (AEDs) such as valproic acid (VPA) are known to affect body weight, and lipid profile. However, evidences regarding effects of AEDs on the body composition are deficient. This cross-sectional study compared the body composition and lipid profile among patients with epilepsy on newer and conventional AEDs.
  
  
  METHODS
  The patients with epilepsy (n=109) on treatment with conventional and newer AEDs (levetiracetam, lamotrigine and clobazam) for > 6 months were enrolled. Of these, 70 were on monotherapy: levetiracetam (n=12), VPA (n=16), carbamazepine (n=20) and phenytoin (n=22) and the remaining on polytherapy. Their body composition [body fat mass, lean dry mass (LDM), total body water (TBW), intracellular water (ICW), extracellular water (ECW) and basal metabolic rate (BMR) was estimated and biochemical parameters were assessed.
  
  
  RESULTS
  Levetiracetam group had no significant difference with VPA, carbamazepine, phenytoin and control groups, except low LDM (17.8±2.4) than VPA groups (20.2±2.7, p<0.05). In comparison with control, AEDs monotherapy groups had no significant difference, except higher LDM and ECW in VPA group. Among groups based on conventional and newer AEDs, there was no significant difference in body composition parameters except for higher LDM (as % of BW) in conventional AEDs only treated group than control (p<0.01).
  
  
  CONCLUSIONS
  The alterations observed in body composition with valproic acid in contrast to other AEDs like levetiracetam, carbamazepine and phenytoin could affect treatment response in epilepsy especially in subjects with already altered body composition status like obese and thin frail patients, which needs to be established by prospective studies (CTRI/2013/05/003701).
authors.affiliation: Department of Pharmacology, All India Institute of Medical Sciences, New Delhi; Department of Pharmacology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
authors.forename: Sudhir Chandra
authors.initials: SC
authors.lastname: Sarangi
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Manjari
authors.initials: M
authors.lastname: Tripathi
authors.affiliation: Department of Pharmacology, All India Institute of Medical Sciences, New Delhi; Department of Pharmacology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
authors.forename: Ashish Kumar
authors.initials: AK
authors.lastname: Kakkar
authors.affiliation: Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Yogendra Kumar
authors.initials: YK
authors.lastname: Gupta
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects*; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects; D001823:Body Composition / Q000187:drug effects*; D001834:Body Water / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects*; D002220:Carbamazepine / Q000008:administration & dosage / Q000009:adverse effects; D000078306:Clobazam; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D000077287:Levetiracetam; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D010889:Piracetam / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D014227:Triazines / Q000008:administration & dosage / Q000009:adverse effects; D014635:Valproic Acid / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000927:Anticonvulsants; D008055:Lipids; D014227:Triazines; D001569:Benzodiazepines; D000078306:Clobazam; D002220:Carbamazepine; D000077287:Levetiracetam; D014635:Valproic Acid; D000077213:Lamotrigine; D010889:Piracetam