Epilepsy drugs increase risk of fractures, falls

Patients taking antiepileptic drugs are up to four times more likely to suffer spine, collarbone and ankle fractures — and more likely to have been diagnosed with osteoporosis, according to research published in Neurology.

The authors also found patients were largely unaware of the risks inherent in taking antiepileptic drugs (AEDs).

“No published studies have explored epilepsy patients’ awareness of the effects of AEDs on bone health, fracture risk and falls,” lead author John Dennis Wark, PhD, stated in a University of Melbourne news release. “This study indicates that awareness of these issues is poor.”

Wark and his colleagues performed a cross-sectional study, comparing fall information and fracture history on 150 AED users with that of 506 non-AED users. AED users, the study found, demonstrated greater odds of fracture at the spine, clavicle and ankle, with increased odds for osteoporosis and fracture incidence.

According to the study abstract, the authors estimated each year of AED use increased fracture odds by 4% to 6%, or 40% per decade for any fracture and 60% for seizure-related fractures. The authors also found that non-seizure-related fractures — 69% of cumulative fractures — occurred more than seizure-related fractures during therapy.

The authors noted fewer than 30% of epilepsy patients they investigated knew of the association between AED use and increased fracture risk or decreased bone mineral density.

“We believe patients need to be offered better information to help them avoid these risks and prevent injury,” Wark stated in the release. “Most patients indicated they would like to be better informed about these issues, suggesting that more effective education strategies are warranted and would be well-received.”

Reference:

Ahmad BS, Hill KD, O’Brien TJ, et al. Falls and fractures in patients chronically treated with antiepileptic drugs. Neurology. 2012. doi: 10.1212/WNL.0b013e31825f0466