Abstracts

Cosmetic side effects (CSEs) occur in a significant number of patients taking antiepileptic drugs (AEDs). Although this type of side effect has been well described for the older AEDs, the relative prevalence of these side effects among the newer AEDs is not known. As part of the Columbia AED Database Project, we reviewed patient background, medical history, AED use, efficacy, and side effects for 1291 patients. CSEs included gingival hyperplasia, hair loss, hirsutism, weight gain, and acne; there were no reports of coarsening of facial features due to AEDs. We compared the overall rate of cosmetic side effects attributed to a particular AED. We repeated this analysis for monotherapy. Additionally, we examined the rate of cosmetic side effects in patients while taking, but not necessarily attributed to, a particular AED. Overall, CSEs were medication specific, occurred in 290/1291 (22%) patients, and led to dosage change or discontinuation in 155/1291 (12%) patients. Of the 753 patients receiving phenytoin (PHT), 45 (6%) developed gingival hyperplasia and 11 (1.5%) developed hirsutism attributed to PHT. Of the 560 patients on valproic acid (VPA), 37 (6.6%) experienced hair loss, and 80 (14.3%) experienced weight gain attributed to VPA. (All p[lt]0.001.) Of the 411 patients receiving gabapentin (GBP), 14 (3.4%) experienced weight gain attributed to GBP (NS). No other cosmetic side effect was attributed to any AED at a rate [gt]1.2%. Results were similar whether on mono- or polytherapy, and were unchanged when including cosmetic side effects that occurred while taking, but not necessarily attributed to, a particular AED. PHT and VPA were associated with cosmetic side effects. PHT was associated with gingival hyperplasia and rarely hirsutism, whereas VPA was associated with weight gain and hair loss. Cosmetic side effects were rarely associated with the newer AEDs. (Supported by Elan, GlaxoSmithKline, Ortho-McNeill, Pfizer, and UCB Pharma)