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Int. J. Mol. Sci. 2016, 17(8), 1242; doi:10.3390/ijms17081242

The Impact of Anti-Epileptic Drugs on Growth and Bone Metabolism

Department of Pediatrics, Tungs’ Taichung Metroharbor Hospital, Wuchi, 435 Taichung, Taiwan
Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, 356 Miaoli, Taiwan
Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, 813 Kaohsiung, Taiwan
Department of Pediatrics, Taipei Veterans General Hospital, 112 Taipei, Taiwan
Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, 112 Taipei, Taiwan
Faculty of Medicine, National Yang-Ming University, 112 Taipei, Taiwan
Department of Pediatrics, Kaohsiung Chang Gung Medical Center, 833 Kaohsiung, Taiwan
Department of Pediatrics, Taichung Veterans General Hospital, 407 Taichung, Taiwan
Author to whom correspondence should be addressed.
Academic Editors: Domenico De Berardis and Wolfram S. Kunz
Received: 13 May 2016 / Revised: 20 July 2016 / Accepted: 28 July 2016 / Published: 1 August 2016
View Full-Text   |   Download PDF [1250 KB, uploaded 1 August 2016]   |  


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. View Full-Text
Keywords: epilepsy; bone metabolism; anti-epileptic drugs (AEDs); classical anti-epileptic drugs (AEDs); newer anti-epileptic drugs (AEDs); cytochrome P450 (CYP450); bone mineral density (BMD) epilepsy; bone metabolism; anti-epileptic drugs (AEDs); classical anti-epileptic drugs (AEDs); newer anti-epileptic drugs (AEDs); cytochrome P450 (CYP450); bone mineral density (BMD)

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Fan, H.-C.; Lee, H.-S.; Chang, K.-P.; Lee, Y.-Y.; Lai, H.-C.; Hung, P.-L.; Lee, H.-F.; Chi, C.-S. The Impact of Anti-Epileptic Drugs on Growth and Bone Metabolism. Int. J. Mol. Sci. 2016, 17, 1242.

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