Written by Greg Arnold, DC, CSCS. This study shows the significant improvement in bone mineral density after a year of calcium and vitamin D supplementation in patients using drugs to treat epilepsy.

Epilepsy is defined by the Centers for Disease Control as “a chronic neurological condition characterized by recurrent seizures.” Epilepsy affects about 2.8 million Americans (2.3 million adults and 467,711 children under 17 years of age), with 150,000 new cases of epilepsy diagnosed in the United States each year at an annual cost of $15.5 billion to our healthcare system (1).

One of the biggest side effects of drugs taken for epilepsy is accelerated bone loss and development of osteoporosis and even fractures (2, 3). The side effects are so severe that chronic use of drugs to control epilepsy is an independent risk factor for fractures (4, 5). As a result, ways to help those on epilepsy drugs maintain bone density is paramount. Now a new study (6) suggests that taking vitamin D and calcium may help.

The study involved 53 male patients diagnosed with epilepsy between the ages of 45 and 76 and participating in the Anti-Epileptic Drug and Osteoporosis Prevention Trial (7). They were given the osteoporosis drug (a class of drug called bisphosphonates) risedronate (35 mg per day = 26 patients) or placebo (27 patients). Both groups were given 1000-1,500 mg per day of calcium and 500-750 IU per day of vitamin D. Patients who had vitamin D levels less than 20 nanograms/milliliter before the study began were given a loading dose of vitamin D of 50,000 IU weekly for 12 weeks before the study began to get those patients to achieve vitamin D levels above 20 ng/ml. All of the patients had blood calcium levels between 8.5-10.5 milligram/deciliter.

After one year of supplementation, those in the risedronate/calcium/vitamin D group had a 3% increase in thigh bone mineral density (p = 0.02). Those in the placebo/calcium/vitamin D group saw a non-significant 2% decrease in their thigh bone mineral density (p = 0.44). In the spine, no change was seen in the placebo group (p = 0.8) while the risedronate group saw a 5.2% increase (p < 0.005). Across the entire body, there was no change in the placebo group (p = 0.10) while there was a 2.1% increase in the risedronate group (p = 0.001).

While there were statistically significant increases in patients on risedronate, the even more optimistic result was the maintenance of bone mineral density in the patients just on the vitamin D and calcium. This led the researchers to conclude, “[these results] support a beneficial effect of [vitamin D and calcium] supplementation on the overall bone health in this patient population.”

Source: Lazzari, Antonio A., et al. “Prevention of bone loss and vertebral fractures in patients with chronic epilepsy—antiepileptic drug and osteoporosis prevention trial.” Epilepsia 54.11 (2013): 1997-2004.

© International League Against Leprosy

Copyright © 1999 – 2017 John Wiley & Sons, Inc.

Posted December 26, 2013.

Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY. You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com

References:

  1. “Epilepsy Fast Facts” posted on the CDC website.
  2. Lotfizadeh HTM, Montouris G. (2004) Bone health in males with epilepsy. Scientific Meeting American Society of Epilepsy, New Orleans, LA.
  3. Carbone LD, Johnson KC, Robbins J, Larson JC, Curb JD, Watson K, Gass M, Lacroix AZ. (2010) Antiepileptic drug use, falls, fractures, and BMD in postmenopausal women: findings from the women’s health initiative (WHI). J Bone Miner Res 25:873–881.
  4. Vestergaard P. (2005) Epilepsy, osteoporosis and fracture risk – a metaanalysis. Acta Neurol Scand 112:277–286.
  5. Vestergaard P, Rejnmark L, Mosekilde L. (2004) Fracture risk associated with use of antiepileptic drugs. Epilepsia 45:1330–1337.
  6. Lazzari AA.  Prevention of bone loss and vertebral fractures in patients with chronic epilepsy—Antiepileptic drug and osteoporosis prevention trial.  Epilepsia. 2013 Nov;54(11):1997-2004. doi: 10.1111/epi.12351. Epub 2013 Sep 6.
  7. ADOPT Study – Clinicaltrials.gov number registration # NCT00869322.