An update on the problem of osteoporosis in people with epilepsy taking antiepileptic drugs.
INTRODUCTION
Antiepileptic drugs (AEDs) have been associated with a negative impact on bone health. Comorbid disorders in patients with epilepsy may require drugs exerting a pro-osteoporotic effect, so a possibility of untoward interactions with AEDs is probable.


AREAS COVERED
This review discusses evidence related to the deteriorating influence of AEDs on bone, demonstrating generally stronger negative effects of conventional AEDs. Lamotrigine seems to be a safer AED in this regard. Further, literature data indicate that generally AEDs can lower the serum concentration of vitamin D. Importantly, pediatric patients are of greater risk of bone problems during therapy with AEDs, which is probably due to their effects on bone-forming processes.


EXPERT OPINION
Supplementation with vitamin D and calcium is frequently recommended in patients taking AEDs chronically. Whether to add a bisphosphonate remains an open question due to the limited data on this issue. A possibility of negative interactions exists between AEDs and other pro-osteoporotic drugs: glucocorticoids, proton pump inhibitors and aromatase inhibitors. Depression is a frequent comorbidity in patients with epilepsy. Clinical data indicate that antidepressant drugs may also increase the risk of fractures. Again, patients with epilepsy and depression may be exposed to a greater risk of osteoporosis.
['Miziak|Barbara|B|', 'Chrościńska-Krawczyk|Magdalena|M|', 'Czuczwar|Stanisław J|SJ|']
D000328:Adult D000818:Animals D000927:Anticonvulsants D000928:Antidepressive Agents D002118:Calcium D002648:Child D003863:Depression D004164:Diphosphonates D004347:Drug Interactions D004827:Epilepsy D006801:Humans D010024:Osteoporosis D058866:Osteoporotic Fractures D012307:Risk Factors D014807:Vitamin D
osteoporosis Antiepileptics bone health bisphosphonates fractures calcium supplementation vitamin D supplementation