title: The Impact of Anti-Epileptic Drugs on Growth and Bone Metabolism.
abstract: Epilepsy is a common neurological disorder worldwide and anti-epileptic drugs (AEDs) are always the first choice for treatment. However, more than 50% of patients with epilepsy who take AEDs have reported bone abnormalities. Cytochrome P450 (CYP450) isoenzymes are induced by AEDs, especially the classical AEDs, such as benzodiazepines (BZDs), carbamazepine (CBZ), phenytoin (PT), phenobarbital (PB), and valproic acid (VPA). The induction of CYP450 isoenzymes may cause vitamin D deficiency, hypocalcemia, increased fracture risks, and altered bone turnover, leading to impaired bone mineral density (BMD). Newer AEDs, such as levetiracetam (LEV), oxcarbazepine (OXC), lamotrigine (LTG), topiramate (TPM), gabapentin (GP), and vigabatrin (VB) have broader spectra, and are safer and better tolerated than the classical AEDs. The effects of AEDs on bone health are controversial. This review focuses on the impact of AEDs on growth and bone metabolism and emphasizes the need for caution and timely withdrawal of these medications to avoid serious disabilities.
authors.affiliation: Department of Pediatrics, Tungs' Taichung Metroharbor Hospital, Wuchi, 435 Taichung, Taiwan. fanhuengchuen@yahoo.com.tw.|Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, 356 Miaoli, Taiwan. fanhuengchuen@yahoo.com.tw.
authors.forename: Hueng-Chuen
authors.initials: HC
authors.lastname: Fan
authors.affiliation: Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, 813 Kaohsiung, Taiwan. herngsheng131419@gmail.com.
authors.forename: Herng-Shen
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Taipei Veterans General Hospital, 112 Taipei, Taiwan. kaipingchang@gmail.com.
authors.forename: Kai-Ping
authors.initials: KP
authors.lastname: Chang
authors.affiliation: Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, 112 Taipei, Taiwan. yylee62@gmail.com.|Faculty of Medicine, National Yang-Ming University, 112 Taipei, Taiwan. yylee62@gmail.com.
authors.forename: Yi-Yen
authors.initials: YY
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Tungs' Taichung Metroharbor Hospital, Wuchi, 435 Taichung, Taiwan. sagelai@yahoo.com.tw.|Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, 356 Miaoli, Taiwan. sagelai@yahoo.com.tw.
authors.forename: Hsin-Chuan
authors.initials: HC
authors.lastname: Lai
authors.affiliation: Department of Pediatrics, Kaohsiung Chang Gung Medical Center, 833 Kaohsiung, Taiwan. flora1402@adm.cgmh.org.tw.
authors.forename: Pi-Lien
authors.initials: PL
authors.lastname: Hung
authors.affiliation: Department of Pediatrics, Taichung Veterans General Hospital, 407 Taichung, Taiwan. leehf@hotmail.com.tw.
authors.forename: Hsiu-Fen
authors.initials: HF
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Tungs' Taichung Metroharbor Hospital, Wuchi, 435 Taichung, Taiwan. chi-cs@hotmail.com.|Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, 356 Miaoli, Taiwan. chi-cs@hotmail.com.
authors.forename: Ching-Shiang
authors.initials: CS
authors.lastname: Chi
mesh_terms: D000927:Anticonvulsants / Q000494:pharmacology*; D015519:Bone Density / Q000187:drug effects*; D006801:Humans; D010012:Osteogenesis / Q000187:drug effects*
chemical_list: D000927:Anticonvulsants
keywords: anti-epileptic drugs (AEDs); bone metabolism; bone mineral density (BMD); classical anti-epileptic drugs (AEDs); cytochrome P450 (CYP450); epilepsy; newer anti-epileptic drugs (AEDs)