OBJECTIVES: In the long-term treatment of multiple forms of epilepsy, antiepileptic drug monotherapy plays a crucial role. This prospective study aimed to prospectively analyze the correlation of serum lipid levels with enzyme-inducing drug monotherapy in the epileptic population and potentiate the risk of Ischemic Heart Disease.

METHODS: This prospective study was conducted for six months. Serum total cholesterol (TC), Triglycerides (TG), Low density lipoprotein cholesterol (LDL-C), High density lipoprotein cholesterol (HDL-C), Very low-density lipoprotein cholesterol (VLDL-C) were measured in 94 patients with epilepsy on AED monotherapy for more than 3 months and in 50 controls not on AED medication. Friedel Wald formula and appropriate descriptive/inferential statistics were performed by using SPSS v 25.

RESULTS: We observed the serum lipid profile of patients on Antiepileptic drugs and compared with the control group. TG (p=0.0004), HDL (p=0.0803), VLDL (p=0.0004) was elevated significantly in patients on Inducers (Carbamazepine, Oxcarbazepine, Phenytoin). The median value of LDL (p=0.0042) was normal in the patients on Non inducers (Lacosamide, Levetiracetam, Lamotrigine) but it was significantly higher when compared with the control group. Patients on Carbamazepine & oxcarbazepine have the increased lipid concentrations in comparison with the controls. TC (p=0.0113), TG (p=0.0059), LDL-C (p=0.0028), VLDL-C (p=0.0059) were significantly increased with Carbamazepine with the highest values followed by changes in TC (P=0.0171), TG (p=<0.0001), LDL-C (p=0.0174), VLDL-C (p=<0.0001) with oxcarbazepine.

CONCLUSIONS: Long term antiepileptic monotherapy with enzyme inducers may cause significant and persistent increase in lipid profile in epileptic population. The increase in the TC, TG, LDL-C, VLDL-C levels maybe associated with the liver enzyme induction. Carbamazepine & Oxcarbazepine exclusively increases the parameters to highly significant values whereas the non inducers did not show any increase. The increase in lipid profile potentiates the risk of ischemic heart disease in patients receiving enzyme inducer antiepileptic drugs.