İnvestigation of the anti-epileptic drug adverse effects on the bone metabolism in epileptic children

İnvestigation of the anti-epileptic drug adverse effects on the bone metabolism in epileptic children Objective: Epilepsy is a chronic disease that starts in childhood and requires long-term treatment and affects the person neurobiologically and psychosocially. There are adverse effects on metabolism in the body, because of anti-epileptic drugs used in the treatment of epilepsy for a long time. In our study, we examined the adverse effects on bone metabolism in epileptic children. Method: Patients who were admitted to Düzce University Pediatrics Clinic with the diagnosis of epilepsy; A total of 111 patients who compliance in the criteria, 68 (% 61,2) with valproic acid untake, 26 (% 23,4) with carbamazepine and 17 (% 15,3) with phenobarbital were included in the study. Blood and urine samples which taken during routine control in the outpatient clinic of the pediatrics were investigated pharmacology laboratory and biochemistry in Düzce University Medical Center. Blood and urine analyses (Ca, P, ALP, PTH, 25 (OH) D, urine calcium / creatinine, drug level) were done. Bone densitometry of children were performed to obtain whole body BMD and z scores. Results: There was no difference in gender distribution between case groups. We found a statistically significant difference between the groups in terms of age and age of diagnosis (p <0,001). There was a significant difference in terms of treatment duration of the patients (p=0,022). Serum calcium, phosphorus, PTH, urine calcium / creatinine and z scores were not different between the three drug groups. The median value of ALP was higher in the phenobarbital group and the lowest in valproic acid group. We found that the median serum vitamin D level was the lowest in all groups but the lowest in the group receiving carbamazepine and the highest in the group with phenobarbital. We found that there was a statistically significant difference between BMD values and the lowest in the phenobarbital group (p=0,001). Conclusions: Patients who used anti-epileptic drugs for a long time due to epilepsy should be provided by more bone health awareness, regular bone dansity checks, intake of calcium and vitamin D. If patients provide more benefit from sunlight and physical activity and select appropriate anti-epileptic drugs for patients metabolism and taking necessary measures, we can identify risky patients early and improve general living standards of epileptic patients. Keywords: Anti-epileptic drugs, Bone metabolism, Bone mineral density, Children, Epilepsy.