The effect of long-term antiepileptic treatment on serum cholesterol (TC, HDL, LDL) and triglyceride levels in adult epileptic patients on monotherapy.

BACKGROUND: Antiepileptic drugs influence, among others, cholesterol and lipoprotein serum levels. MATERIAL/
METHODS: Serum cholesterol (TC, HDL-c, and LDL-c) and triglyceride (TG) levels were measured in 103 epileptic patients receiving chronic antiepileptic monotherapy and in 103 age- and sex-matched controls.
RESULTS: Compared with controls, patients on carbamazepine showed significant higher TC, HDL-c, and LDL-c and non significantly higher TG values. Patients on phenobarbital showed no statistically significant differences in TC, HDL-c, LDL-c and TG values. Patients on phenytoin showed significantly higher LDL-c values and non-significant differences in TC, HDL-c and TG values. Patients on valproate showed significantly lower TC, LDL-c and TG values and non-significant differences in HDL-c values. Changes in serum lipid profiles did not correlate with drug plasma levels.
CONCLUSIONS: Our results suggest a need for monitoring serum TC, HDL-c, LDL-c and TG levels and, perhaps, prescribing a low-cholesterol diet in patients receiving carbamazepine and phenytoin, but not phenobarbital.