Anticonvulsant therapy-induced alterations in calcium homeostasis

ABSTRACT

35 epileptic patients, aged 10 to 58 years [mean 23], who were taking anticonvulsant drugs were studied. The patients exhibited a 34% reduction in serum calcium levels, a 41% increase in serum alkaline phosphatase activity and a slight but insignificant decrease in serum phosphate, compared to untreated controls. These changes appear to be related to the anticonvulsant drug taken, in the following order of decreasing importance phenytoin + phenobarbital + carbamazepine; phenytoin + phenobarbital; phenytoin + carbamazepine, and phenobarbital + carbamazepine. It is possible that anticonvulsant drugs alter vitamin D metabolism which results in disturbance of calcium homeostasis. Moreover these changes in serum calcium and alkaline phosphatase activity in anticonvulsant treatment patients are similar to those in patients with osteomalacia