SERUM-LIPID LEVELS DURING CARBAMAZEPINE MEDICATION - A PROSPECTIVE-STUDY

Objective.-The aim of the study was to evaluate serum lipid levels dur ing carbamazepine medication. Design.-A 5-year prospective follow-up s tudy. Setting.-Outpatient department, University Central Hospital of O ulu (Finland).Patients.-Thirty-six consecutive untreated patients with recently diagnosed idiopathic epilepsy. All patients completed the 1 -year follow-up, and 19 patients completed the 5-year follow-up. Inter ventions.-The patients were treated with carbamazepine for their newly diagnosed seizure disorder. Main Outcome Measures.-Serum lipid levels were followed up during the medication use. Results.-Serum total chol esterol and high-density lipoprotein cholesterol concentrations increa sed after 2 months of treatment with carbamazepine and remained high a fter 1 and 5 years. Furthermore, concentrations of serum low-density l ipoprotein cholesterol and triglycerides increased transiently during the first year of medication. The increase in serum total cholesterol levels correlated with an increase in serum gamma-glutamyltransferase concentrations. Conclusions.-Serum lipid levels change during carbamaz epine medication; the increase in serum concentrations of total choles terol and high-density lipoprotein cholesterol seems permanent, but th e increase in serum low-density lipoprotein cholesterol and triglyceri de levels is transient. The change in lipid metabolism may be associat ed with induction of the liver enzymes during carbamazepine medication . The increase in serum cholesterol and high-density lipoprotein chole sterol levels may have clinical relevance with regard to the incidence of atherosclerosis and coronary heart disease in patients with epilep sy receiving carbamazepine medication.