COMPARISON BETWEEN CARBAMAZEPINE AND VALPROATE ON LIPID PROFILE AND LIPOPROTEIN (a)

Introduction: Aseizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in behaviour, movements or feelings, and in level of consciousness The high incidence of epilepsy in children coupled with the need of long term antiepileptic treatment could lead to development of metabolic complications at an early age and hence the risk of atherosclerosis. The changes in serum lipid and lipoprotein (a) levels do play an important role in atherosclerosis and cardiovascular complications in later life. Aim: In view of the above facts the present study aims to evaluate the change in the level of lipids and lipoprotein (a) during the course of treatment of epilepsy with different antiepileptic drugs. Materials and Methods:Aprospective follow up study was conducted on 19 children (10 on carbamazepine and 9 on valproate) in Department of Paediatrics at Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana. The duration of study was one and a half year. A detailed history was taken with complete clinical examination. Biochemical parameters like lipid prole, Lipoprotein(a), liver enzymes along with relevant investigations were done before starting anti- epileptic monotherapy and were followed up after 6 month of treatment.Results: Out of 19 children with seizure 10 on carbamazepine showed signicant increase (p < 0.05) in the levels of lipoprotein (a), TG (triglyceride), TC (total cholesterol), LDL(low density lipids), VLDL(very low density lipids) after six months of treatment and 9 children on Valproate didn't show signicant increase in lipid prole and lipoprotein (a) whereas has signicant change in levels of SGPT (p <0.05) after six month of monotherapy. Conclusion: Several antiepileptic drug like carbamazepine with CYP450 enzyme inducers activity may cause signicant rise in levels of lipids and lipoprotein (a), hence causing a potent risk factor for atherorsclerosis and cardiovascular complications in long term antiepileptic therapy; thus lipid prole and lipoprotein (a) should be monitored during the course of treatment