Abstract

Purpose: Treatment with antiepileptic drugs is known to affect lipid concentrations in serum. However, little is known about the effects of anticonvulsant drugs (AEDs) on lipoprotein (a) [Lp(a)], although Lp(a) has been characterized as independent cardiovascular risk factor. We investigated the effect of antiepileptic drugs on Lp(a) concentration and lipid profili in epileptic patients.

Methods: Serum lipids, apolipoproteins A and B, and Lp(a) levels were measured in 48 epileptic patients receiving chronic treatment with carbamazepine, phenytoin or valproic acid and in 18 age- and sex-matched control subjects.

Results: When compared to controls, subjects treated with carbamazepine and phenytoin showed significantly higher values of VLDL-cholesterol, apolipoprotein A, TG and Lp(a) concentrations and subjects treated valproic acid showed significantly higher values of Lp(a) and apolipoprotein A levels. HDL-cholesterol was significantly lower in patients in all groups. Changes in serum lipids profile either did not correlate with drug plasma concentrations or the duration of the treatment.

Conclusions: These findings suggest that long-term antiepileptic treatment is associated with changes in the lipoprotein metabolism and could increase serum Lp(a) concentrations. Elevated Lp(a) levels might be a risk factor for arteriosclerosis in epileptic patients.