Lipoprotein(a) concentration increases during treatment with carbamazepine

Epilepsia. 2003 Mar;44(3):457-60. doi: 10.1046/j.1528-1157.2003.44802.x.

Abstract

Purpose: Treatment with carbamazepine (CBZ) is known to affect apolipoprotein B-containing lipoprotein concentrations in serum. However, little is known about the effects of anticonvulsant drugs (AEDs) on lipoprotein(a) [Lp(a)], although Lp(a) has been characterized as independent cardiovascular risk factor. We investigated prospectively the effect of CBZ on lipoprotein(a) concentration in normolipidemic healthy adults.

Methods: Twenty male volunteers were included in the study. Lp(a) levels were determined before and 69 +/- 19 days after CBZ administration by using an enzyme-linked immunoassay.

Results: CBZ (mean plasma concentration, 6.6 +/- 0.6 microg/ml) caused a significant increase in Lp(a) concentrations, with a median change of +19.5% (95% CI: +8.2, +53.3; p < 0.001). Total cholesterol, low density lipoprotein (LDL) cholesterol, and triglycerides also increased significantly.

Conclusions: Although the precise mechanism of action of CBZ on Lp(a) elevation remains uncertain, it might be related to its enzyme-inducing properties. During treatment with CBZ, special focus should be given to elevated LDL cholesterol and Lp(a) concentrations with regard to increased risk for atherosclerotic vascular diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anticonvulsants / adverse effects
  • Anticonvulsants / pharmacology*
  • Anticonvulsants / therapeutic use
  • Carbamazepine / adverse effects
  • Carbamazepine / pharmacology*
  • Carbamazepine / therapeutic use
  • Cholesterol / blood
  • Cholesterol, LDL / blood
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / etiology
  • Diabetic Neuropathies / drug therapy
  • Humans
  • Lipoprotein(a) / blood*
  • Male
  • Prospective Studies
  • Risk Factors
  • Stimulation, Chemical
  • Supine Position
  • Triglycerides / blood

Substances

  • Anticonvulsants
  • Cholesterol, LDL
  • Lipoprotein(a)
  • Triglycerides
  • Carbamazepine
  • Cholesterol