Duration and dose of antiepileptic drugs and serum calcium levels in children
Abstract: Antiepileptic drugs
(AEDs) may affect calcium metabolism through several mechanisms. Much evidence
has confirmed that carbamazepine and valproic acid, as the most widely used
AEDs in epileptic children, leads to decreased serum calcium levels. This
effect was suggested to be time and dose dependent. However, correlations
between AEDs and calcium levels in Indonesian epileptic children have not been
well studied.
Objective To investigate possible correlations between total calcium
levels and durations of therapy as well as doses of carbamazepine and valproic
acid.
Methods This analytical, cross-sectional study was performed from March
to May 2015 in the Neuropediatric Outpatient Ward of Mohammad Hoesin Hospital,
Palembang, South Sumatera. A total of 60 epileptic children taking
carbamazepine and or valproic acid monotherapy were included and grouped accordingly.
A single blood test was done for every participant to measure total serum
calcium level. Correlation between daily dose or duration of AED with calcium
level was assess using the Spearman-rho test.
Results The mean total serum calcium levels in the carbamazepine and
valproic acid groups were 9.48 (SD 0.83) mg/dL and 9.58 (SD 0.63) mg/dL,
respectively. There was a statistically significant moderate correlation
between the duration of carbamazepine therapy and total calcium level (r =
0.36; P=0.001). The cut-off point for duration of therapy was 23 months. There
were no significant correlations between total calcium level and mean daily
carbamazepine dose, nor between total calcium level and duration and dose of
valproic acid therapy.
Conclusion Longer duration of carbamazepine therapy is associated with
low total serum calcium level, but carbamazepine dose is not. In addition,
duration and dose of valproic acid are not associated with low total serum calcium
level.
Keywords: calcium levels;
therapeutic durations; drug doses; antiepileptic drugs
Author: Arinta Atmasari,
Masayu Rita Dewi, Aditiawati Aditiawati, Masagus Irsan Saleh
Journal Code: jpkedokterangg170098
