Studies on adverse metabolic effects of antiepileptics and their correlation with blood components.

Epilepsy is a neurological disorder knowing no geographical or social boundaries. Majority of patients can be treated with conventional drugs like phenytoin, phenobarbitone and car-bamazepine. The present study was planned to correlate the metabolic side effects with the serum drug levels to bridge the existing gap between clinical and biochemical evaluation. Correlation of serum concentration of antiepileptics with thyroid profile, lipid profile, liver enzymes and electrolytes was carried out in 130 known patients of epilepsy on monotherapy or combination therapy. Phenytoin, carbamazepine and phenobarbitone estimation was done using High Pressure Liquid Chromatography. All the groups showed an increase in mean alkaline phosphatase and thyroid-stimulating hormone concentration as compared to healthy age and sex matched individuals. Significant positive correlation was found between serum carbamazepine and serum aspartate transaminase and alanine transaminase concentration (p<0.005). It was concluded that metabolic alterations are mostly mild and clinically insignificant and do not justify routine testing, except in those known to have a coexisting or recently developed hepatic abnormality.