ArticleActa epileptologica2026
Long-term effects of carbamazepine on bone-related biochemical markers in patients with epilepsy.
Article in Acta epileptologica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCarbamazepine (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.
methodsAn 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.
resultsThe 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.
conclusionsThe 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.
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