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Epilepsy drug fracture risk in over 55s

By Christian Duffin

Older patients are more likely to experience fractures of the wrist, hip and vertebrea if they are taking antiepileptic drugs, a population-based analysis has shown.

Researchers from Canada studied data linked to 16,000 patients over 50 years old. Patients were prescribed either carbamazepine, clonazepam, gabapentin, phenobarbital and phenytoin and all showed a significantly higher risk of non-traumatic fractures.

The adjusted odds ratios ranged from 1.24 for clonazepam to 1.91 for phenytoin. Gabapentin increased the risk of fractures by 49%, phenobarbital by 60%, and carbamazepine by 81%. Valproate was not associated with a statistically significant increase in fracture risk.

Study leader Dr Nathalie Jetté, a clinical neurologist at the University of Calgary concluded: ‘Most antiepileptic drugs were associated with an increased risk of non-traumatic fractures in older people. Further studies are warranted to assess the risk of non-traumatic fractures with the newer AEDs and to determine the efficacy of osteoprotective medications in this population.’

Arch Neurol. 2011;68(1):107-112

Epilepsy drug fracture risk in over 55s