Vitamin D, Calcium Improves Bone Density in Epileptic Patients

BOSTONVitamin D and calcium supplementation improves bone density in patients taking antiepileptic drugs (AEDs), according to a new study in Epilepsia, a journal of the International League Against Epilepsy (ILAE).

Epilepsy patients often chronically take AEDs such as henytoin, phenobarbital, carbamazepine, primidone and valproate to control seizures, but these medications have been demonstrated to accelerate bone loss. Previous studies have shown 50 percent of epileptic patients taking AEDs exhibit decreased bone mass in their hips or spine.

Long-term use of AEDs is associated with loss of bone mass and increased risk of osteoporosis," explains Dr. Antonio Lazzari, M.D., with the VA Boston Healthcare System in Massachusetts and lead author of the present study. Our study is the first longitudinal trial of a bisphosphonate (risedronate), along with calcium and vitamin D supplementation, in preventing and treating bone loss in male veterans with epilepsy receiving AED therapy."

The antiepileptic drug and osteoporosis prevention trial (ADOPT) analyzed 80 male epileptic veterans treated with an AED for at least two years (Epilepsia. 2013 Nov;54(11):1997-2004. doi: 10.1111/epi.12351). In the two-year randomized, double blind, placebo-controlled study, all participants received calcium and vitamin D supplements. They were then randomized to risedronate or placebo; all patients received bone density assessments at baseline, one and two years.

Researchers found significant improvements in bone density in 69 and 70 percent of patients in the placebo and active drug groups; risedronate subjects showed a significant increase in lumbar spine bone density, compared to placebo.

Dr. Lazzari explained, Our findings suggest calcium and vitamin D with or without risedronate improves bone density in epilepsy patients taking AEDs. However five new vertebral fractures were observed in the placebo group and none in the active medication group. Adding risedronate to the supplements appears to prevent new fractures in this group of veterans."