Vascular risk linked to long-term antiepileptic drug therapy

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.

Media Contact

Dawn Peters EurekAlert!

Weitere Informationen:

http://www.wiley.com

Alle Nachrichten aus der Kategorie: Health and Medicine

This subject area encompasses research and studies in the field of human medicine.

Among the wide-ranging list of topics covered here are anesthesiology, anatomy, surgery, human genetics, hygiene and environmental medicine, internal medicine, neurology, pharmacology, physiology, urology and dental medicine.

Zurück zur Startseite

Kommentare (0)

Schreib Kommentar

Neueste Beiträge

How Stable is the Antarctic Ice Sheet?

Scientists from Heidelberg University investigate which factors determine the stability of ice masses in East Antarctica. As temperatures rise due to climate change, the melting of polar ice sheets is…

Smart sensors for future fast charging batteries

European project “Spartacus” launched Faster charging, longer stability of performance not only for electric vehicles but also for smartphones and other battery powered products. What still sounds like science fiction…

Small molecules control bacterial resistance to antibiotics

Antibiotics have revolutionized medicine by providing effective treatments for infectious diseases such as cholera. But the pathogens that cause disease are increasingly developing resistance to the antibiotics that are most…

Partners

By continuing to use the site, you agree to the use of cookies. more information

The cookie settings on this website are set to "allow cookies" to give you the best browsing experience possible. If you continue to use this website without changing your cookie settings or you click "Accept" below then you are consenting to this.

Close