The effect of long-term antiepileptic treatment on serum cholesterol (TC, HDL, LDL) and triglyceride levels in adult epileptic patients on monotherapy

Antiepileptic drugs influence, among others, cholesterol and lipoprotein serum levels. Serum cholesterol (TC, HDL-c, and LDL-c) and triglyceride (TG) levels were measured in 103 epileptic patients receiving chronic antiepileptic monotherapy and in 103 age- and sex-matched controls. Compared with controls, patients on carbamazepine showed significant higher TC, HDL-c, and LDL-c and non significantly higher TG values. Patients on phenobarbital showed no statistically significant differences in TC, HDL-c, LDL-c and TG values. Patients on phenytoin showed significantly higher LDL-c values and non-significant differences in TC, HDL-c and TG values. Patients on valproate showed significantly lower TC, LDL-c and TG values and non-significant differences in HDL-c values. Changes in serum lipid profiles did not correlate with drug plasma levels. Our results suggest a need for monitoring serum TC, HDL-c, LDL-c and TG levels and, perhaps, prescribing a low-cholesterol diet in patients receiving carbamazepine and phenytoin, but not phenobarbital.