AEDs & Loss of Bone Mass
American researchers have established that young men on long-term anti-seizure medication (AED) therapy may be at risk for significant loss of hip bone density.
Researchers at outpatient seizure clinics at the Veterans Affairs Puget Sound Health Care System and the University of Washington School of Medicine in Seattle used dual-energy X-ray absorptiometry to determine the mineral density of the femoral bone in 81 men, 25 to 54 years of age. Low bone mineral density (BMD) values were analysed for recognised bone loss risk factors. 12 to 29 months later, 54 participants were assessed again using absorptiometry to determine the change rate of BMD over time. Longitudinal analysis revealed considerable declines in femoral BMD in the younger men (25 to 44 years of age) on long term AED therapy.
Multivariate linear regression determined that age and the duration of AED therapy are the 2 most important factors associated with low femoral BMD. After correction for age and duration of AED therapy, no associations were found between low BMD and vitamin D deficiency, hypogonadism, tobacco smoking or excessive alcohol consumption. Although no specific anti-seizure medication was identified as causing more bone loss, most participants were taking carbamazepine or phenytoin sodium during longitudinal assessment.
Clinicians suggest that dual-energy radiographic absorptiometry scanning of the hip may prove useful in identifying those most at risk for rapid bone loss.
Sources
Archives of Neurology 2002 Vol 59 No 5 pp 781-786. "Antiepileptic Drug–Induced Bone Loss in Young Male Patients Who Have Seizures"
http://archneur.ama-assn.org/issues/v59n5/abs/noc10256.html
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