This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kafali, G. Articles by Tanzer, F. Search for Related Content PubMed PubMed Citation Articles by Kafali, G. Articles by Tanzer, F. Social Bookmarking                   What's this?

Effect of Antiepileptic Drugs on Bone Mineral Density in Children Between Ages 6 and 2 Years

Department of Pediatrics, Cumhuriyet University Faculty of Medicine, Sivas, Turkey

Taner Erselcan, MD

Department of Nuclear Medicine, Cumhuriyet University Faculty of Medicine, Sivas, Turkey

Fato Tanzer, MD

Department of Pediatrics, Cumhuriyet University Faculty of Medicine, Sivas, Turkey

We assessed the effects of sodium valproate and carbamazepine monotherapy on bone mineral density (BMD) in children. BMD at the lumbar vertebrae (L₁-L₄) and radius-ulna was measured by the dual-energy x-ray absorptiometry (DEXA) method in 19 children (9 girls, 10 boys) with uncomplicated epilepsy and in 57 healthy children (28 girls, 29 boys), between the ages of 6 and 12 years. The study patients had been receiving either sodium valproate (n=13) or carbamazepine (n=6) monotherapy for more than 6 months. There were no significant differences between the control and study patients in age, height, weight, physical activity, or of serum concentrations of calcium, phosphate, and transaminases (aspartate aminotransferase, alanine aminotransferase). However, the serum alkaline phosphatase concentration was greater in the patient group as compared with the control group. BMD values were lower in girl patients (L₁-L₄; 0.497 0.08 vs 0.566 0.07 g/cm², p<0.05), but not in boys (0.534 0.06 vs 0.530 0.08 g/cm²). While BMD reduction was 8% in valproate therapy (midregion of radius-ulna; 0.287.03 vs 0.312 04 g/cm², p<0.04), it was reduced only 4.5% in the carbamazepine-treated group (0.298 01 vs 0.312 04 g/cm², statistically not significant), although the mean durations of monotherapy with valproate (1.8 7 years) and carbamazepine (1.7 8 years) were similar. Thus decreased bone mineralization was observed in children with epilepsy, treated with sodium valproate even though treatment was for a rather short time.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				K. E. Ensrud, T. S. Walczak, T. L. Blackwell, E. R. Ensrud, E. Barrett-Connor, E. S. Orwoll, and For the Osteoporotic Fractures in Men (MrOS) Study Antiepileptic drug use and rates of hip bone loss in older men: A prospective study Neurology, September 2, 2008; 71(10): 723 - 730. [Abstract] [Full Text] [PDF]

				R. D. Sheth, N. Binkley, and B. P. Hermann Progressive bone deficit in epilepsy Neurology, January 15, 2008; 70(3): 170 - 176. [Abstract] [Full Text] [PDF]

				H. Tekgul, G. Serdaroglu, A. Huseyinov, and S. Gokben Bone Mineral Status in Pediatric Outpatients on Antiepileptic Drug Monotherapy J Child Neurol, May 1, 2006; 21(5): 411 - 414. [Abstract] [PDF]

				P. Nicolaidou, H. Georgouli, H. Kotsalis, Y. Matsinos, A. Papadopoulou, A. Fretzayas, V. Syriopoulou, X. Krikos, A. Karantana, and T. Karpathios Effects of Anticonvulsant Therapy on Vitamin D Status in Children: Prospective Monitoring Study J Child Neurol, March 1, 2006; 21(3): 205 - 210. [Abstract] [PDF]

				S. J. Petty, L. M. Paton, T. J. O'Brien, J. Makovey, B. Erbas, P. Sambrook, S. F. Berkovic, and J. D. Wark Effect of antiepileptic medication on bone mineral measures Neurology, November 8, 2005; 65(9): 1358 - 1365. [Abstract] [Full Text] [PDF]

				K. A. Voudris, A. Attilakos, E. Katsarou, A. Garoufi, S. Dimou, A. Skardoutsou, and S. Mastroyianni Early Alteration in Bone Metabolism in Epileptic Children Receiving Carbamazepine Monotherapy Owing to the Induction of Hepatic Drug-Metabolizing Enzymes J Child Neurol, June 1, 2005; 20(6): 513 - 516. [Abstract] [PDF]

				K. A. Voudris, A. Attilakos, E. Katsarou, A. Garoufi, S. Dimou, A. Skardoutsou, and S. Mastroyianni Early Alteration in Bone Metabolism in Epileptic Children Receiving Carbamazepine Monotherapy Owing to the Induction of Hepatic Drug--Metabolizing Enzymes J Child Neurol, June 1, 2005; 20(6): 513 - 516. [Abstract] [PDF]

				G. D. Anderson Pharmacogenetics and enzyme induction/inhibition properties of antiepileptic drugs Neurology, November 23, 2004; 63(10_suppl_4): S3 - S8. [Abstract] [Full Text]

				G. Farhat, B. Yamout, M. A. Mikati, S. Demirjian, R. Sawaya, and G. El-Hajj Fuleihan Effect of antiepileptic drugs on bone density in ambulatory patients Neurology, May 14, 2002; 58(9): 1348 - 1353. [Abstract] [Full Text] [PDF]

				R. D. Sheth Adolescent Issues in Epilepsy J Child Neurol, February 1, 2002; 17(2_suppl): 2S23 - 2S27. [Abstract] [PDF]

				C. Valmadrid, C. Voorhees, B. Litt, and C. R. Schneyer Practice Patterns of Neurologists Regarding Bone and Mineral Effects of Antiepileptic Drug Therapy Arch Neurol, September 1, 2001; 58(9): 1369 - 1374. [Abstract] [Full Text] [PDF]

				Y. Sato, I. Kondo, S. Ishida, H. Motooka, K. Takayama, Y. Tomita, H. Maeda, and K. Satoh Decreased bone mass and increased bone turnover with valproate therapy in adults with epilepsy Neurology, August 14, 2001; 57(3): 445 - 449. [Abstract] [Full Text] [PDF]

				V. Umpaichitra, W. Bastian, and S. Castells Hypocalcemia in Children: Pathogenesis and Management Clinical Pediatrics, June 1, 2001; 40(6): 305 - 312. [Abstract] [PDF]