Changes of serum lipid levels after antiepileptic medication in epileptic patients after brain infarction

Abstract

Dyslipidemia is a well-known cardio- and cerebro-vascular risk factor. Older antiepileptic drugs (AEDs), including carbamazepine (CBZ), phenytoin (PHT) and phenobarbital, induce the hepatic cytochrome P450 (CYP) system that is extensively involved in the synthesis and metabolism of cholesterols. Those AEDs can increase the potential of dyslipidemia development. The present study sought to examine the changes of serum lipid levels after the single administration of valproate (VA), CBZ, PHT, zonisamide (ZNS), levetiracetam (LEV) or lamotrigine (LTG) for 3 months in epileptic patients after cerebral infarction. CBZ or PHT monotherapy increased the serum TC and LDL-C levels significantly. The serum levels of TC and LDL-C did not differ significantly after the administration of VA, ZNS, LEV, or LTG. Serum HDL-C and TG levels did not differ after treatment with any AEDs significantly. Thus, we should pay more attention to serum lipid levels in post-stroke epileptic patients treated with CYP-induced AEDs. For the secondary prevention of brain infarction, switching to non-CYP-induced AEDs might be considered in patients who CYP-induced AEDs increased serum LDL-C levels.