Impact of Antiepileptic Therapy on Bone-Mineral Density in Young Women

Phenytoin — but not carbamazepine, lamotrigine, or valproate — reduced bone-mineral density at the femoral neck over a 1-year period.

Antiepileptic drug (AED) therapy has been associated with decreased bone-mineral density (BMD) and increased risk for osteoporotic fractures. Whether certain AEDs are more detrimental to bone than others is unclear. In this 1-year longitudinal study, partially supported by the manufacturer of lamotrigine, researchers followed 93 women (all premenopausal with normal menses; mean age, 32) on AED monotherapy. The AEDs were carbamazepine (n=41), lamotrigine (n=23), valproate (n=14), and phenytoin (n=15). At baseline and 1 year later, the authors measured BMD at the lumbar spine and hip, markers of bone turnover, and serum calciotropic hormone levels.

The 93 subjects were well matched at baseline. At 1 year, the women on phenytoin sustained a sig…

Reviewing Author

Carolyn B. Becker, MD

Impact of Antiepileptic Therapy on Bone-Mineral Density in Young Women

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Reviewing Author