Effects of Long term Antiepileptic Drugs on Vascular Risk Factors and Atherosclerosis

Ravi, L A (2013) Effects of Long term Antiepileptic Drugs on Vascular Risk Factors and Atherosclerosis. Masters thesis, Madras Medical College, Chennai.


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Epilepsy is one of the most common disorders of the brain.1 One of every ten people will have at least one epileptic seizure during a normal lifespan and a third of these will develop epilepsy. 50 million people are affected by epilepsy worldwide, accounting for 1% of the global burden of disease, equivalent to lung cancer in men and breast cancer in women. More than 30% of epileptic patients have to undergo longterm therapy with antiepileptic drugs.3 Prolonged AED therapy is associated with several adverse effects such as metabolic disturbances, idiosyncratic reactions, behavioral or psychiatric problems and drug interactions. Risk factors for atherosclerotic events and cardiovascular disease include male sex, increased age, elevated plasma total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), decreased high-density lipoprotein cholesterol (HDL-C), CRP, high blood pressure, smoking and diabetes mellitus.5-7 Annegers et al8 in their study have reported a high death rate due to ischemic heart disease and sudden cardiac death in symptomatic epileptic patients. But however a clarity on the issue of AED intake leading to cardiovascular mortality is not very clear. In this context there have been few studies that have indicated that long term AED intake has been associated with increased vascular risk factors. With this background the study of long term effects of antiepileptic drugs on vascular risk factors and atherosclerosis was conducted. AIMS OF THE STUDY : 1. To study the effect of antiepileptic drugs on vascular risk factors namely serum Lipid profile and CRP in epileptic patients. 2. To assess the effect of antiepileptic drugs on carotid intima media thickness, a marker of atherosclerosis in epileptic patients. 3. To assess the correlation between duration of the antiepileptic drugs, and carotid intima media thickness. CONCLUSION : The following conclusions were observed from our study. 1. Epileptic patients on carbamazepine and phenobarbitone had significantly elevated levels of serum total cholesterol, LDL-cholesterol and CRP. HDL-cholesterol level, Triglyceride and body mass index were not significantly altered in these groups. 2. Patients on phenytoin and sodium valproate had significantly elevated body mass index. There was no significant effect on lipid levels and CRP in this group. 3. All the antiepileptic drugs in this study significantly increased the common carotid artery intima media thickness. 4. It is observed that there is significant positive correlation between duration of phenobarbitone therapy and average common carotid artery intima media thickness which was not noted with carbamazepine, phenytoin and sodium valproate. This study of antiepileptic drugs on vascular risk factors will have a bearing on the selection of AEDs in refractory epileptic patients and elderly patients. Hence a lonterm study has to be conducted in a large sample of epileptic patients to assess the effects of AEDs on vascular risk factors especially in those requiring long term AEDs and in elderly patients.

Item Type: Thesis (Masters)
Additional Information: Reg.No.16101006
Uncontrolled Keywords: Long term Antiepileptic Drugs, Vascular Risk Factors, Atherosclerosis.
Subjects: MEDICAL > Neurology
Depositing User: Kambaraman B
Date Deposited: 30 Jun 2017 02:37
Last Modified: 27 Mar 2020 08:14
URI: http://repository-tnmgrmu.ac.in/id/eprint/659

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