Effect of long-term valproate monotherapy on bone mineral density in adults with epilepsy

Triantafyllou, Nikos; Lambrinoudaki, Irini; Armeni, Elena; Evangelopoulos, Eleftheria-Maria; Boufidou, Fotini; Antoniou, Aris; Tsivgoulis, Georgios

doi:10.1016/j.jns.2009.12.015

« Previous Next »Journal of the Neurological Sciences
Volume 290, Issue 1 , Pages 131-134, 15 March 2010

Effect of long-term valproate monotherapy on bone mineral density in adults with epilepsy

Nikos Triantafyllou
- Department of Neurology, University of Athens, Eginition Hospital, Athens, Greece
Irini Lambrinoudaki
- Second Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Athens, Greece
Elena Armeni
- Second Department of Obstetrics and Gynecology, University of Athens, Areteion Hospital, Athens, Greece
Eleftheria-Maria Evangelopoulos
- Department of Neurology, University of Athens, Eginition Hospital, Athens, Greece
Fotini Boufidou
- Department of Neurology, University of Athens, Eginition Hospital, Athens, Greece
Aris Antoniou
- Department of Nuclear Medicine, University of Athens, Areteion Hospital, Athens, Greece
Georgios Tsivgoulis
- Department of Neurology, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
- Corresponding author. Kapodistriou 3, Nea Xili, Alexandroupolis 68100, Greece. Tel.: +30 6937178635; fax: +30 2551030479.

Received 10 September 2009; received in revised form 5 November 2009; accepted 16 December 2009. published online 07 January 2010.

Abstract

Background

We evaluated the cross-sectional relationship of duration and dosage of valproate monotherapy on bone mineral density (BMD) in adult patients with epilepsy.

Methods

The BMD at lumbar level (L2–L4) was measured in consecutive adult epileptic patients receiving long-term (≥2years) valproate monotherapy by dual energy X-ray absorptiometry (DXA). Blood samples were collected for total serum calcium, phosphorus, magnesium, 25-hydroxyvitamin D₃ and parathormone. Osteopenia and osteoporosis were defined according to the World Health Organization operational BMD definition. Cross-sectional associations were evaluated using Spearman's correlation coefficient.

Results

A total of 41 patients were studied (mean age 32.3±8.2years, 12 men, mean duration of valproate monotherapy 10.6±7.4years). Osteopenia was present in 24% of subjects, while no case of osteoporosis was documented. Duration and dosage of valproate monotherapy did not correlate with BMD. No association was documented between duration or dosage of valproate monotherapy and biochemical parameters.

Conclusions

Duration of valproate monotherapy does not correlate with decreased BMD in adult patients with epilepsy. No case of osteoporosis was identified in patients treated with valproate for a mean period of more than ten years. These findings indicate that bone metabolism may not be affected by valproate monotherapy.

Keywords: Epilepsy, Valproate, Bone mineral density