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Article

Bone disease associated with antiepileptic drugs

Alison M. Pack, MD, Barry Gidal, PharmD and Blanca Vazquez, MD
Cleveland Clinic Journal of Medicine February 2004, 71 (2 suppl 2) S42-S48;
Alison M. Pack
Neurological Institute, Columbia Presbyterian Medical Center, New York, N.Y.
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Barry Gidal
University of Wisconsin, Madison, Wisc.
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Blanca Vazquez
New York University School of Medicine, New York, N.Y.
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ABSTRACT

Antiepileptic drugs (AEDs) are associated with bone disease. Early reports found rickets in children and osteomalacia in adults, but those reports were primarily in institutionalized persons. Studies in ambulatory adults and children taking AEDs do not reveal rickets or osteomalacia but do report abnormalities in biochemical indexes of bone mineral metabolism and density. In addition, fracture rates are increased in AED-treated patients. AEDs that induce the cytochrome P450 enzyme system are most commonly associated with abnormalities in bone. Emerging data suggest that valproate, an enzyme inhibitor, may also affect bone, and there is limited information on the newer AEDs. Several theories on the mechanism of AED-associated bone disease have been proposed, but no single one explains all the reported findings. Identifying AED-treated patients who are at risk for or have bone disease is important, as multiple therapies are available.

  • Copyright © 2004 The Cleveland Clinic Foundation. All Rights Reserved.
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Cleveland Clinic Journal of Medicine: 71 (2 suppl 2)
Cleveland Clinic Journal of Medicine
Vol. 71, Issue 2 suppl 2
1 Feb 2004
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Bone disease associated with antiepileptic drugs
Alison M. Pack, Barry Gidal, Blanca Vazquez
Cleveland Clinic Journal of Medicine Feb 2004, 71 (2 suppl 2) S42-S48;

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Bone disease associated with antiepileptic drugs
Alison M. Pack, Barry Gidal, Blanca Vazquez
Cleveland Clinic Journal of Medicine Feb 2004, 71 (2 suppl 2) S42-S48;
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