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Effect of switching hepatic enzyme‐inducer antiepileptic drug to levetiracetam on bone mineral density, 25 hydroxyvitamin D , and parathyroid hormone in young adult patients with epilepsy
Author(s) -
Phabphal Kanitpong,
Geater Alan,
Limapichat Kitti,
Sathirapanya Pornchai,
Setthawatcharawanich Suwanna,
Leelawattana Rattana
Publication year - 2013
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.12162
Subject(s) - levetiracetam , phenytoin , parathyroid hormone , medicine , bone mineral , epilepsy , vitamin d and neurology , endocrinology , osteoporosis , calcium , psychiatry
Summary We sought to determine the effect of changing phenytoin therapy on bone mineral density ( BMD ) and 25‐hydroxyvitamin D in patients with epilepsy. Of the 90 patients, 54 patients had switched to levetiracetam, 19 patients had stopped, and 17 patients continued taking phenytoin. We proposed a 2‐year period to examine 25‐hydroxyvitamin D , parathyroid hormone, and BMD . The patients who switched or stopped phenytoin showed a significant increase in BMD of the lumbar spine and left femur, and in 25‐hydroxyvitamin D . In contrast, those who continued phenytoin had a significant decrease in BMD at both sites and in 25‐hydroxyvitamin D . Patients who were taken off phenytoin and those switching to levetiracetam did not show a significant difference in BMD , 25‐hydroxyvitamin D , parathyroid, or calcium at follow‐up. Compared with those who continued phenytoin, the BMD was significantly higher in patients switching to levetiracetam and those who stopped using phenytoin. Switching medications may be necessary in some cases to avoid low BMD .