The effect of carbamazepine on biochemical bone profile in epileptic patients

الملخص EN

Objectives : To assess the biochemical bone profile in epileptic patients treated with carbamazepine monotherapy which include serum total calcium, phosphorus levels and alkaline phosphatase activity, and to investigate the relationship between these parameters with the age of the patients, daily dose of the drug and the duration of treatment.

Design : Case-control study.

Setting : The study was carried out in the Outpatient department of Ibin-Seena Hospital in Mosul, during the period from October ٢٠٠٢ to March ٢٠٠٣.

Participants : Seventy six epileptic patients on carbamazepine therapy and ٧٦ apparently healthy subjects as a control group.

Main outcomes measures : Serum total calcium, phosphorus levels and alkaline phosphatase activity in epileptic patients treated with carbamazepine were compared with their corresponding values in the control group by using "Z" test.

The relationship between serum total calcium, phosphorus levels and alkaline phosphatase activity, with the age of the epileptic patients, daily dose or duration of treatment of carbamazepine, were also studied by using correlation coefficient.

Results : In epileptic patients treated with carbamazepine, serum total calcium was significantly lower (P < ٠.٠٠١) than the control group, while serum alkaline phosphatase activity was significantly higher (P < ٠.٠٠١) than the controls.

At the same time, serum phosrus level was significantly higher (P < ٠.٠٥) in those patients than the controls, although still within the normal range.

No correlation was found between the ages of the epileptic patients treated with carbamazepine and their serum total calcium, phosphorus levels and alkaline phosphatase activity.

Furthermore, no correlation was found between the daily dose of carbamazepine for those epileptic patients and their biochemical bone profile.

However, significant correlation was noticed between the duration of treatment of carbamazepine and serum calcium level (r = -٠.٣٠٣) and alkaline phosphatase activity (r = ٠.٣).

Conclusion : This study encourage the use of carbamazepine for epilepsy as a sole therapy as no evidence of Anticonvulsant Osteomalacia.

In addition, periodic biochemical checks for bone profile are indicated for epileptic patients.