EFFECTS OF LONG-TERM TREATMENT WITH ANTIEPILEPTIC DRUGS ON SERUM-LIPID LEVELS IN CHILDREN WITH EPILEPSY

We determined serum levels of total cholesterol (TC), high-density lip oprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL -C), very low-density lipoprotein cholesterol (VLDL-C), and triglyceri des (TGs) in 125 healthy children and in 119 children with epilepsy wh o had been receiving carbamazepine (58 children), phenobarbital (22 ch ildren), or valproic acid (39 children) for 7 months to 10.5 years (me an, 5.8 years). None of the variables considered was significantly cor related with time elapsed since start of treatment or with drug concen tration in serum. In the groups receiving carbamazepine or phenobarbit al, mean TC, HDL-C, and LDL-C levels were higher than in the control g roup, the differences being statistically significant for all except L DL-C in the phenobarbital group. In neither group did mean TC/HDL-C ra tio or mean LDL-C/HDL-C ratio differ significantly from the correspond ing control-group mean. In the group receiving valproic acid, mean TC level, mean LDL-C level, mean TC/HDL-C ratio, and mean LDL-C/HDL-C rat io were significantly lower than in the control group. In none of the treated groups did mean VLDL-C or TG level differ significantly from t he corresponding control-group mean. Our results suggest, in contrast to previous reports, that the effects on the serum lipid profile of lo ng-term treatment with hepatic-enzyme-inducing antiepileptic drugs (su ch as carbamazepine and phenobarbital) are probably not beneficial as regards risk of atherosclerosis-related disease. Our results additiona lly suggest a need for careful monitoring of serum cholesterol levels in children with epilepsy receiving carbamazepine or phenobarbital.