Abstracts

Rationale: Antiepileptic drugs (AEDs) may influence total cholesterol (TC) and lipoprotein serum levels. Patients treated with Carbamazepine (CBZ) have showed significant higher TC, LDL , apolipoprotein B serum levels. HDL findings have been more inconsistent. These changes may increase risk for atherosclerotic vascular diseases. It is therefore important to know if such negative effects on serumlipids are reversible. Methods: We used a prospective, randomized and double blinded design. Complete serum samples from before and 4 months after completed withdrawal/no withdrawal were obtained from 83 patients using CBZ (41females, 42 males). Student`s t-test and chi-square test were used for testing group differences and mean differences in change between the two groups for continuous and categorical variables, respectively. Results: Mean baseline values were: TC 5.51mmol/l(1.34), HDL 1.04mmol/l, LDL 3.38mmol/l(1.21), apolipoprotein A 1.73g/l(0.32), apolipoprotein B 0.98(0.32). Mean differences in change in TC, LDL and apolipoprotein B between the withdrawal group and non-withdrawal group were - 0.68 mmol/l (p=0.005, CI - 1.15- - 0.21), - 0.67 mmol/l (p=0.001, CI - 1.03- -0.29), - 0.13g/l (p=0.02, CI - 0.23- -0.03) respectively. No significant changes were seen in HDL or apolipoprotein A. Conclusions: We found significant decrease in TC, LDL and apolipoprotein B in patients treated with CBZ in the withdrawal group after withdrawal compared the non-withdrawal group. This supports prior findings that CBZ may have potentially negative effects on TC, LDL, and apolipoprotein B serum levels, and may contribute to an increased risk for cardio-vascular events in this group of patients. The new and important finding in our study, however, was that the changes were reversible, even after years on treatment. Effects of antiepileptic drugs on blood lipids have to be considered in treating patients with epilepsy.