BONE METABOLISM IN HEALTHY AMBULATORY CONTROL PREMENOPAUSAL WOMEN AND IN EPILEPTICS ON ANTI-CONVULSANT DRUGS

Abstract

Background: Long term anti-epileptic drug use causes multiple abnormalities incalcium and bone metabolism that have been documented in both institutionalisedand ambulatory patients.

Objective: To assess bone metabolism in ambulatory females of reproductive age, onantiepileptic drugs.Design: Cross sectional comparative study.

Subjects: Ambulatory females in reproductive age group with epilepsy and on regularfollow up were compared to healthy females of similar ages not on any treatment.

Results: The mean duration of treatment for epilepsy was eight years (±6.3). Majorityof the patients were on enzyme inducing drugs like phenobarbital, phenytoin,carbamazepine and valproate, either alone or in combination with non-enzyme inducerslike lamotrigine (98.2%). There was a significantly lower mean serum calcium and ahigher alkaline phosphatase level among the patients (P=0.002 and 0.0001 respectively)than among the comparators. The urinary marker of bone loss (mean urine calciumexcretion) was also significantly raised among the patients (P=0.003). The mean lumbarBMDT-score results were not significantly different in the two groups.

Conclusions: Long-term anti-epileptic drug use significantly affects biochemicalparameters of bone metabolism. These effects on bone biochemistry markers werenot reflected in lumbar spine BMD in this study.