The effects of treatment with antiepileptic drugs on serum lipid levels in adult patients with epilepsy

Abstract

Background: The aim of this study was to evaluate and compare the effects of standard and new antiepileptic drugs on the serum lipid levels of adult patients with epilepsy.

Methods: We retrospectively reviewed the data for 236 adult patients with epilepsy who were receiving standard (old) or modern (new) antiepileptic drugs in monotherapy or polytherapy. The data were collected from the hospital information system of the University Clinical Hospital Mostar for epilepsy patients treated from January 1 to December 31, 2019. The total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) serum levels were analyzed. Statistical Package for the Social Sciences (SPSS) software version 25.0 was used for statistical data analysis, and a comparison of the categorical and continuous variables was undertaken with χ2. Variables with a p-value of <0.05 were considered statistically significant.

Results: Antiepileptic drugs with the cytochrome P450 (CYP450) enzyme-inducing mechanism, such as phenobarbital, carbamazepine and oxcarbazepine, were not statistically significantly associated with elevated total cholesterol, LDL-C or triglyceride levels. Methylphenobarbital use was statistically significantly linked with raised cholesterol levels (p=0.033). Valproate and new generation antiepileptic drugs such as levetiracetam, lamotrigine, pregabalin, and gabapentin, which are not inducers of the CYP450 enzyme, do not affect the total cholesterol, LDL-C or triglyceride serum levels.

Conclusion: The majority of antiepileptic drugs from the group of CYP450 enzyme-inducers do not increase the total cholesterol, LDL-C, or triglyceride levels in patients with epilepsy. However, methylphenobarbital use causes an increase in total cholesterol levels. New generation antiepileptics do not affect the total cholesterol, LDL-C, or triglyceride serum levels.