Abstract:
Background: Epileptic patients take multiple antiepileptic drugs (AEDs) which have been shown to increase the risk of bone fractures. Few studies have investigated the affects of AED monotherapy.
Objective: To assess the risk of fracture of epilepsy patients taking Carbamazepine (Tegretol) monotherapy via bone mineral
density as measured by dual energy X-ray absorptiometry (DEXA) scan T-scores of femoral necks and spine. Methods: A retrospective chart review was conducted for 123 epileptic patients, between the ages of 12-80, at the Via-Christi
Comprehensive Epilepsy Center in Wichita, Kansas who were on antiepileptic medications for at least two years, and had
undergone a DEXA bone scan. Results: Of 123 patients 5 were found to be on Carbamazepine monotherapy. Of these 5 patients there were 4 females and 1 male with an average age of 42 years and an average duration on Carbamazepine therapy of 5.7 years. The average DEXA scan T score was noted to be in the good bone health range with a value of -0.07. The lowest DEXA T score was attributed to the single male and found to be in the osteopenic range with a value of -1.2. The single male case did not have the longest duration of carbamazepine therapy though he was the only patient among the 5 to be non-ambulatory. A negative correlation was found between duration on carbamazepine therapy and DEXA T-score. Patients taking carbamazepine for greater than 9 years developed osteopenia. Conclusions: Overall the longer patients were taking Carbamazepine (Tegretol) the lower their DEXA femoral neck and spine T scores were suggesting that carbamazepine may increase the risk of bone fractures. The male patient case had the lowest T-score, but not the longest duration of carbamazepine therapy, suggesting that risk of fracture and bone mineral density have multiple contributing factors including the ability to ambulate and hormonal effects. Further investigation with a larger sample size is warranted to better assess these contributing factors.
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