Anticonvulsant Drugs and Bone Disease in the Elderly

Elderly psychiatric inpatients were studied to find the prevalence of osteomalacia in those taking anticonvulsant medication (n = 19) and a comparison group not taking these drugs (n = 37). Only one biopsy-proven case was discovered among the anticonvulsant group, and none in the comparison group. T...

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Bibliographic Details
Published in:Journal of the Royal Society of Medicine 1987-07, Vol.80 (7), p.425-427
Main Authors: Harrington, M G, Hodkinson, H M
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Alkaline Phosphatase - metabolism
Anticonvulsants - adverse effects
Bone and Bones - drug effects
Bone and Bones - metabolism
Female
Humans
Liver - enzymology
Male
Osteomalacia - chemically induced
Osteomalacia - metabolism
Vitamin D - metabolism
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Summary:Elderly psychiatric inpatients were studied to find the prevalence of osteomalacia in those taking anticonvulsant medication (n = 19) and a comparison group not taking these drugs (n = 37). Only one biopsy-proven case was discovered among the anticonvulsant group, and none in the comparison group. This was an unexpectedly low rate. The clinical and biochemical data (including alkaline and acid phosphatase isoenzymes) were further analysed to detect subclinical osteomalacia, but none was found. A difference between the two subgroups was found for total and liver alkaline phosphatase only. The possible explanations for these unexpected findings are discussed. The effect of anticonvulsants on vitamin D and bone metabolism is reviewed and the hypothesis that drug-induced changes in vitamin D metabolism are responsible for the bone changes described in earlier series is questioned.
ISSN:0141-0768
1758-1095
DOI:10.1177/014107688708000710