Effects of eslicarbazepine acetate on lipid profile and sodium levels in patients with epilepsy

Purpose Several studies have demonstrated that treatment with enzyme-inducing antiepileptic drugs is associated with increased serum lipid levels. Eslicarbazepine acetate (ESL) is a novel antiepileptic drug specifically designed with the objective to identify carbamazepine and oxcarbazepine analogues with favorable pharmacodynamic and pharmacokinetic profiles. The present study aimed to assess the changes in lipid profile and sodium levels in patients with epilepsy taking ESL as adjunctive therapy. Method This report describes a retrospective cohort study of 36 adult patients with epilepsy, taking ESL as an add-on treatment. The laboratory values assessed prior and after (range 6–18 months) ESL treatment were sodium levels, total cholesterol (TC), low (LDL) and high (HDL) density lipoproteins and triglycerides. Results TC and LDL values were significantly decreased already after at least six months of therapy with ESL (191.3 ± 29.6 vs 179.7 ± 29.2 mg/dl, p < 0.0001 and 114.58 ± 22.7 vs 103.11 ± 19.46 mg/dl, p < 0.0001 respectively). HDL values before and during ESL treatment were significantly increased (57.5± 9.1 vs 63.9 ± 8.3 mg/dl; p < 0.0001). No statistically significant changes have been found in triglycerides and sodium values. Conclusions Add-on therapy with ESL, in contrast to the negative effects observed with traditional older carboxamides, positively affects lipid metabolism profile in patients with epilepsy over an average follow-up of 11 months. Further research is needed to confirm the obtained results with a focus on a comprehensive assessment of the biochemical and molecular mechanisms involved. © 2017 British Epilepsy Association