In a study carried out by an Australian
research team on 150 epileptics taking AEDs, only 30% of them knew that these
drugs increase their risk for falls, fractures and decrease bone mineral
density (BMD) and also, have a negative impact on their bone metabolism.
Though the subjects attended specialist
epilepsy clinics, only 23% of them were aware of the fact that most fractures
in epilepsy patients were not linked to seizures. However, 70% of the epilepsy
patients studied expressed a keen interest to know more about the impact of
AEDs on bone health.
Interestingly, the study also helped to
confirm the increased fracture risk in AED- administered patients.
The average age of the patients studied was
30 years and they were on AED for nearly 20 years. The subjects were then
compared to 506 gender and age-matched patients without epilepsy (non AED
-users). It was found that AED users were more predisposed to osteoporosis,
spinal fractures, clavicle fractures, and ankle fractures.
It was estimated that each additional year of
AED use elevated the patients' fracture risk by 4% for all fractures.
The researchers noted that 69% of all
fractures that occurred in epileptic patients were not directly related to
Alison Pack of USA's Columbia University
writes in an editorial that accompanied the study, in Neurology,
"This study highlights the need for better
education on the risk of fracture, falls, and adverse effects of bone health
among persons with epilepsy treated with AEDs
"Additional well-designed controlled
studies are needed to better understand the effect of epilepsy and AED therapy
on osteoporosis and fall and fracture risk. Future studies should determine the
differential effect of specific AEDs, particularly given the availability of
multiple AED agents," Pack sums up in her editorial.