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      Carbamazepine Therapy May Increase Bone Turnover

      A DGReview of :"Increased Bone Turnover in Prepubertal, Pubertal, and Postpubertal Patients Receiving Carbamazepine."
      Epilepsia

      12/12/2002
      By Alison Palkhivala


      Carbamazepine appears to increase bone turnover in paediatric patients, based on serum measurements of markers for bone formation and resorption.

      In a study led by A. Verrotti from the department of medicine, section of paediatrics, University of Chieti, Italy, investigators measured the bone turnover of 60 children with epilepsy being treated with carbamazepine. They stratified the patients according to pubertal stage and compared them to a control group of 60 healthy children, who were matched in terms of age and sex.

      Following two years of carbamazepine therapy, patients taking the drug had higher serum concentrations of markers for bone formation and bone resorption than patients not taking the drug. Despite these changes, all patients had normal vitamin D metabolism.

      Markers of bone formation measured were bone alkaline phosphatase, osteocalcin, carboxy-terminal peptide of type I procollagen and amino-terminal propeptide of type III procollagen. Markers of bone resorption measured were carboxy-terminal telopeptide of type I collagen and the urinary cross-linked N-telopeptides of type I collagen.

      According to the authors, carbamazepine may increase bone formation and resorption, and this effect appears to be independent of pubertal age.
      Epilepsia 2002 Dec;43(12):1488-1492. "Increased Bone Turnover in Prepubertal, Pubertal, and Postpubertal Patients Receiving Carbamazepine."

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