Effects of long term antiseizure medications on atherosclerosis

Babu BS, Varghese CP, Gilvaz PC

Pdf Page Numbers :- 329-335

Surendra Babu B¹, Prasanth Varghese C^1,* and Gilvaz PC¹

¹Department of Neurology, Jubilee Mission Medical College & research Institute, Thrissur, Kerala - 680005, India

*Corresponding author: Dr. Prasanth Varghese C, Asst. Professor, Department of Neurology, Jubilee Mission Medical College & research Institute, Thrissur, Kerala - 680005, India. Email: prasanthneuro@gmail.com

Received 25 July 2023; Revised 12 September 2023; Accepted 19 September 2023; Published 27 September 2023

Citation: Babu BS, Varghese CP, Gilvaz PC. Effects of long term antiseizure medications on atherosclerosis. J Med Sci Res. 2023; 11(4):329-335. DOI: http://dx.doi.org/10.17727/JMSR.2023/11-60

Copyright: © 2023 Babu BS et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Long-term therapy with antiseizure medications (ASMs) has been associated with metabolic consequences that lead to an increase in the risk of atherosclerosis in patients with epilepsy. This study was conducted to assess the effects of ASMs on vascular risk factors namely, serum Lipid profile and C-reactive protein (CRP) in epileptic patients and to assess the correlation between the duration of the ASMs, and carotid intima media thickness (IMT). Forty three adult patient participants who were receiving ASM monotherapy for more than 2 years and 43 control patients were enrolled in this study. All participants received measurement of common carotid artery (CCA) and IMT by B-mode ultrasonography to assess the extent of atherosclerosis. Other measurements included body mass index (BMI), serum lipid profile and CRP. The correlation between duration of ASM and average carotid IMT was calculated by using the Pearson's correlation coefficient method. The majority of subjects on phenytoin 8 (66.7%) were positive for CRP. There was an equal proportion of patients on carbamazepine who were equally positive 5(50%) and negative 5(50%) for CRP. There was a statistically significant association between phenytoin consumption and CRP positivity. There was positive correlation between duration of phenytoin consumption and average IMT. There was a strong positive correlation between duration of phenobarbitone consumption and average IMT and was statistically significant. Our results also suggest that long-term use of ASMs with prominent effects on the enzyme system, including Carbamazepine, phenytoin, sodium valproate or phenobarbitone may contribute to the progression of atherosclerosis in patients with epilepsy.

Keywords: epilepsy; ASMs; IMT; CRP; phenytoin; carbamazepine; sodium valproate; phenobarbitone