ABSTRACT

The aim of our study was to investigate the presence of increased cardiovascular risk in epileptic children treated with carbamazepine. This study was designed to evaluate the relation of carbamazepine and atherosclerosis by investigating the effect of carbamazepine on antioxidant capacity, lipid profile, oxidized low-density lipoprotein (LDL), and carotid artery intima-media thickness (C-IMT).

Twenty-one children aged between 2 and 16 years with epilepsy who were treated with carbamazepine were included in the study. Triglyceride, total cholesterol, high-density lipoprotein, LDL, lipid hydroperoxide, paraoxonase, arylesterase levels, and C-IMT were measured in all patients before the treatment, at the 3rd and 6th months of the treatment.

Thirteen (61.9%) of the patients were male, and 8 (38.1%) were female. The mean age of the patients was 111.48±44.81 months. There was a significant increase in total cholesterol, arylesterase, and paraoxonase levels at the 6th months of the treatment compared with pre-treatment levels. No significant changes were observed in C-IMT values.

Our study is the first study in the literature in which the relation between arylesterase and paraoxonase levels and CIMT in pediatric patients before and after carbamazepine treatment was prospectively investigated. The exact mechanism of carbamazepine on atherosclerosis is not clearly understood. These results demonstrate that these patients could be at increased risk of the development of cardiovascular complications. In light of these findings, future studies in epileptic children should be to plan antioxidant capacity, cholesterol level, and measuring C-IMT with ultrasonography periodically in long term. We think that these findings enhance our understanding of the relationship between oxidative stress and antiepileptic drugs.

Keywords: Atherosclerosis, carbamazepine, carotid intima-media thickness, epilepsy