Długotrwałe skutki karbamazepiny na wskaźniki biochemiczne związane z zdrowiem kości u pacjentów z epilepsją

BACKGROUND: Carbamazepine (CBZ) is a commonly prescribed antiseizure medication frequently prescribed for epilepsy, trigeminal neuralgia, and mood disorders. However, CBZ is a strong inducer of cytochrome P450 enzymes, which can accelerate the catabolism of vitamin D and potentially alter bone metabolism. This study aimed to evaluate the effects of long-term CBZ administration on bone health in patients with epilepsy. METHODS: An observational study involving 226 patients was conducted at King Abdulaziz Medical City in Jeddah, Saudi Arabia. We analyzed the pre- and post-treatment serum levels of vitamin D (nmol/L), alkaline phosphatase (U/L), sodium (mmol/L), and calcium (mmol/L) to assess biochemical changes associated with prolonged CBZ therapy. RESULTS: The analysis of vitamin D revealed a significant decrease after CBZ treatment (mean ± SD= 36.6 ± 15.68 nmol/L) compared to pre-treatment (45 ± 23.25 nmol/L) with a 95% CI of -14.47 to -2.37 and P = 0.007. Additionally, following the administration of CBZ, serum levels of calcium and sodium were both significantly reduced with P < 0.001 and P = 0.019, respectively. However, alkaline phosphatase levels showed no significant change. CONCLUSIONS: The study outcomes suggest a potential association between long-term CBZ use and bone health, as supported by the presence of biochemical abnormalities. Furthermore, these findings underscore the importance of proactive clinical screening and bone-preserving interventions. Moreover, further studies are recommended to address the management of epilepsy patients with impaired bone health.