Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Vascular risk linked to long-term antiepileptic drug therapy

15.11.2011
Hardening of arteries may occur in patients with long-term use of older antiepileptic drugs

New research reveals that patients with epilepsy who were treated for extended periods with older generation antiepileptic drugs (AEDs) may be at increased risk for developing atherosclerosis, a common disorder known as hardening of the arteries. According to the findings now available in Epilepsia, the journal of the International League Against Epilepsy (ILAE), the vascular risk is significantly associated with the duration of AED monotherapy.

While the majority of epilepsy patients have good results with treatment, more than 30% of patients continue to have seizures even with AED therapy. In these cases of refractory epilepsy, long-term or lifelong AED therapy is needed. Prolonged treatment can lead to diabetes, thyroid issues, psychiatric problems and adverse drug reactions. Prior studies suggest that older-generation AEDs such as phenytoin, carbamazepine, phenobarbital, and valproic acid may alter metabolic pathways, contributing to increased vascular risks.

Lead author, Dr. Yao-Chung Chuang from Kaohsiung Chang Gung Memorial Hospital in Taiwan, and colleagues compared the long-term impact of different categories of AED monotherapy on atherosclerosis development. The team recruited 160 adult patients with epilepsy who had received AED monotherapy for more than 2 years, along with 60 healthy controls. Ultrasonography was used to measure participants' common carotid artery (CCA) intima media thickness (IMT) -- a measurement used to assess the extent of atherosclerosis.

"Our study found patients with epilepsy who were under long-term monotherpy with phenytoin, carbamazepine and valproic acid displayed significantly increased CCA IMT measurements," said Dr. Chuang. "These altered circulatory markers from prolonged AED therapy may accelerate the atherosclerotic process." Analysis showed that CCA IMT is positively correlated with the duration of AED therapy.

Researchers also investigated specific vascular risk factors associated with the type of AED therapy. Epilepsy patients taking carbamazepine or phenytoin for long periods exhibited increased levels of cholesterol and of the amino acid, total homocysteine (tHcy), and lower levels of folate, all of which increase risk of adverse cardiovascular and cerebrovascular events. Patients who were treated with valproic acid displayed elevated levels of uric acid, tHcy, and thiobarbituric acid reactive substances (TBARS), increasing atherosclerosis risk which the authors believe is based on oxidative mechanisms.

The authors argue that drug choice should be carefully selected for epilepsy patients requiring long-term AED treatment, particularly in elderly or individuals at high-risk of vascular events. Dr. Chuang concluded, "Our findings suggest that newer AEDs, such as lamotrigine, may minimize metabolic disturbances, and therefore reduce the risk of atherosclerosis brought on by long-term AED therapy."

This study is published in Epilepsia. Media wishing to receive a PDF of this article may contact healthnews@wiley.com.

Full citation:"Effects of Long-Term Antiepileptic Drug Monotherapy on Vascular Risk Factors and Atherosclerosis." Yao-Chung Chuang, Hung-Yi Chuang, Tsu-Kung Lin, Chiung-Chih Chang, Cheng-Hsien Lu, Wen-Neng Chang, Shang-Der Chen, Teng-Yeow Tan, Chi-Ren Huang, and Samuel H.H. Chan. Epilepsia; November 15, 2011 (DOI: 10.1111/j.1528-1167.2011.03316.x).

Epilepsia is the leading, most authoritative source for current clinical and research results on all aspects of epilepsy. As the journal of the International League Against Epilepsy, subscribers every month will review scientific evidence and clinical methodology in: clinical neurology, neurophysiology, molecular biology, neuroimaging, neurochemistry, neurosurgery, pharmacology, neuroepidemiology, and therapeutic trials. For more information, please visit http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1528-1167.

Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit http://www.wileyblackwell.com or our new online platform, Wiley Online Library (http://www.wileyonlinelibrary.com), one of the world's most extensive multidisciplinary collections of online resources, covering life, health, social and physical sciences, and humanities.

Dawn Peters | EurekAlert!
Further information:
http://www.wiley.com

Further reports about: AED Epilepsia Epilepsy IMT risk factor uric acid vascular cells

More articles from Health and Medicine:

nachricht Organ-on-a-chip mimics heart's biomechanical properties
23.02.2017 | Vanderbilt University

nachricht Researchers identify cause of hereditary skeletal muscle disorder
22.02.2017 | Klinikum der Universität München

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

Stingless bees have their nests protected by soldiers

24.02.2017 | Life Sciences

New risk factors for anxiety disorders

24.02.2017 | Life Sciences

MWC 2017: 5G Capital Berlin

24.02.2017 | Trade Fair News

VideoLinks
B2B-VideoLinks
More VideoLinks >>>