The Hematologic Effect of Antiepileptic Drugs

ABSTRACT

PURPOSE: There have been controversies on the hematologic effects of antiepileptic drugs according to the mono or combined antiepileptic therapy. We evaluated the hematologic changes of the patients who have been taking antiepileptic drugs for more than 4 months and compared the changes of these values according to the mono or combined therapy. METHODS: From May, 1989 to April, 1995, we had examined the blood samples of 89 patients 1) when they were diagnosed as the convulsive disorder and 2) when they had taken antiepileptic drugs for more than 4 months so that their serum drug concentration was enough to be effective for the seizure control. We classified these patients as 4 groups according to the drugs they had taken; 1st group population treated with valproic acid, 2nd group population treated with carbamazepine, 3rd group population treated with phenobarbital and 4th group population treated with combined antiepileptic drugs (mostly valproic acid with other antiepileptic drugs). We examined and compared their hematologic values such as counts of white blood cell (WBC), red blood cell (RBC), platelet and hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC). RESULTS: 1) Mean age of the patients was 6.9+/-4.1 year and the mean duration of antiepileptic medication was 3.5+/-1.2 years. Age and the duration of medication had no influence on the study. 2) No significant differences were found on the WBC, RBC, Hb, Hct and MCHC before and after the medication in all the groups. 3) Statistically significant changes were found on MCV and MCH values before and after the medication in the 1st and 4th group (p<0.05, each group). CONCLUSIONS: We observed the significant increases on MCV and MCH in the patients who had taken valproic acid singly or combined with other antiepileptic drugs. It is necessary to take periodic CBC follow up to evaluate the changes of MCV and MCH in these patients. Additional investigation is needed to obtain the hamatologic side effects according to the various dosing regimens and durations of drug administration.