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Anti-Epilepsy Drugs May Cause Bone Fractures in Older People

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According to the January issue of Archives of Neurology, anti-epilepsy drugs are associated with an increased risk of non-traumatic fractures in people over the age of 50.
Epilepsy is prevalent in older people, according to Patient UK, and this age range have a higher likelihood of osteoporosis. If they are also taking medication for epilepsy, this risk is heightened as anti-epilepsy drugs are considered a secondary risk factor for osteoporosis.

For women who are taking anti-epilepsy drugs, there may also be bone density loss after menopause.

Nathalie Jetté, M.D., M.Sc., of the University of Calgary, Foothills Hospital, Alberta, Canada, and colleagues studied medical records of 15,792 individuals who experienced non-traumatic fractures between April 1996 and March 2004. Each person was matched with up to three controls, persons without a history of fracture, for a total of 47,289 controls.

They found that the drugs carbamazepine, clonazepam, gabapentin, phenobarbital, and phenytoin caused a significant increase in fractures. The only anti-epileptic drug not associated with fractures was valproic acid.

Similar results were found when testing for the use of anti-epileptic drugs in monotherapy (individuals taking only one anti-epileptic drug) and in polytherapy (individuals taking more than one anti-epileptic drug). All anti-epileptic drugs used in monotherapy were associated with a significantly increased risk of fracture except for valproic acid, phenobarbital and "other anti-epileptic drugs." The greatest risk of fracture was found in individuals in the polytherapy subgroups.

The study authors concluded
‘Most AEDs were associated with an increased risk of non-traumatic fractures in individuals aged 50 years or older. Further studies are warranted to assess the risk of nontraumatic fractures with the newer AEDs and to determine the efficacy of osteoprotective medications in this population.’

Source: Arch Neurol. 2011;68(1):107-112. doi:10.1001/archneurol.2010.341

Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/.

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