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Review

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

by
Hueng-Chuen Fan
1,2,
Herng-Shen Lee
3,
Kai-Ping Chang
4,
Yi-Yen Lee
5,6,
Hsin-Chuan Lai
1,2,
Pi-Lien Hung
7,
Hsiu-Fen Lee
8 and
Ching-Shiang Chi
1,2,*
1
Department of Pediatrics, Tungs’ Taichung Metroharbor Hospital, Wuchi, 435 Taichung, Taiwan
2
Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, 356 Miaoli, Taiwan
3
Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, 813 Kaohsiung, Taiwan
4
Department of Pediatrics, Taipei Veterans General Hospital, 112 Taipei, Taiwan
5
Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, 112 Taipei, Taiwan
6
Faculty of Medicine, National Yang-Ming University, 112 Taipei, Taiwan
7
Department of Pediatrics, Kaohsiung Chang Gung Medical Center, 833 Kaohsiung, Taiwan
8
Department of Pediatrics, Taichung Veterans General Hospital, 407 Taichung, Taiwan
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2016, 17(8), 1242; https://doi.org/10.3390/ijms17081242
Submission received: 13 May 2016 / Revised: 20 July 2016 / Accepted: 28 July 2016 / Published: 1 August 2016
(This article belongs to the Special Issue Commemorative Issue in Honor of Professor Uwe Heinemann: Metabolic Epilepsies)
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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.
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)
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MDPI and ACS Style

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. https://doi.org/10.3390/ijms17081242

AMA Style

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. International Journal of Molecular Sciences. 2016; 17(8):1242. https://doi.org/10.3390/ijms17081242

Chicago/Turabian Style

Fan, Hueng-Chuen, Herng-Shen Lee, Kai-Ping Chang, Yi-Yen Lee, Hsin-Chuan Lai, Pi-Lien Hung, Hsiu-Fen Lee, and Ching-Shiang Chi. 2016. "The Impact of Anti-Epileptic Drugs on Growth and Bone Metabolism" International Journal of Molecular Sciences 17, no. 8: 1242. https://doi.org/10.3390/ijms17081242

APA Style

Fan, H.-C., Lee, H.-S., Chang, K.-P., Lee, Y.-Y., Lai, H.-C., Hung, P.-L., Lee, H.-F., & Chi, C.-S. (2016). The Impact of Anti-Epileptic Drugs on Growth and Bone Metabolism. International Journal of Molecular Sciences, 17(8), 1242. https://doi.org/10.3390/ijms17081242

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