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Favorable change of lipid profile after carbamazepine withdrawal
Author(s) -
Lossius M. I.,
Nakken K. O.,
Mowinckel P.,
Taubøll E.,
Gjerstad L.
Publication year - 2016
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12534
Subject(s) - carbamazepine , apolipoprotein b , phenytoin , phenobarbital , medicine , lamotrigine , epilepsy , drug withdrawal , randomized controlled trial , endocrinology , cholesterol , pharmacology , drug , psychiatry
Objective Patients treated with carbamazepine ( CBZ ) have increased serum levels of total cholesterol ( TC ), high‐density lipoproteins ( HDL ), and low‐density lipoproteins ( LDL ). We aimed to investigate whether these changes of serum lipids are reversible after CBZ withdrawal. Material and methods We used a prospective, randomized double‐blinded design. A total of 160 patients who had been seizure free on anti‐epileptic drug monotherapy for more than 2 years were included and randomized to withdrawal or not. The intervention was completed by 150 (80 females, 53%) patients. Serum samples from before and 4 months after completed withdrawal or no withdrawal were obtained from 130 patients (63 females, 48%). Of these, 84 were treated with CBZ, 28 with valproate, nine with phenytoin, four with phenobarbital, and five with lamotrigine. Of the patients who had been treated with CBZ, 47 were randomized to the withdrawal group, and 37 were randomized to the non‐withdrawal group. Results Among the CBZ‐treated patients, a significant decrease in serum levels of TC, LDL, and apolipoprotein B (ApoB) were found in the withdrawal group compared with the non‐withdrawal group. Mean differences in change were as follows: TC 0.68 mmol/l ( P = 0.005, CL – 1.15 to −0.21); LDL – 0.67 mmol/l ( P = 0.001, CL – 1.03 to −0.29); ApoB – 0.13 g/l ( P = 0.02, CL – 0.23 to −0.03). No significant changes in HDL, apolipoprotein A, and C‐reactive protein were detected. Conclusion Our results indicate that CBZ may have unfavorable effects on serum levels of TC, LDL, and ApoB. However, these changes seem to be reversible even after years of treatment.