Estimation of liver enzymes in patients taking antiepileptic drugs in a tertiary care center: A cross-sectional study

Abstract

Background: A number of antiepileptic drugs (AEDs) are used in the management of epilepsy. Almost all AEDs undergo hepatic biotransformation. Since drugs contribute a major part in causing liver injury, there is a need for identifying it. This study was designed to estimate the prevalence of liver enzyme elevation among patients treated with AEDs. Aims and Objectives: This study aims to estimate the prevalence of liver enzyme elevation and/or liver dysfunction in patients receiving AEDs. Materials and Methods: This cross-sectional descriptive study was conducted in the Department of Neurology, Tirunelveli Medical College Hospital for a period of 6 months. About 150 patients on AEDs, who met the inclusion and exclusion criteria, participated in the study. Demographic data, disease history, drug history, and history of any adverse drug reactions were recorded. Venous blood sample was collected to analyze complete blood count, serum aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Results: Among 150 patients, 86 were male and 64 were female. Of these, 109 patients were on monotherapy with carbamazepine, sodium valproate, phenytoin, or phenobarbitone and rest 41 were on combination therapy. Serum AST levels were elevated in four patients treated with sodium valproate, phenytoin, or phenobarbitone as monotherapy, whereas ALT enzyme elevation was observed only in one male patient who was on sodium valproate as monotherapy. Serum alkaline phosphatase (ALP) was elevated in 14 patients and decreased in three patients. Conclusion: The magnitude of elevation in serum AST, ALT, and ALP levels with AEDs was found to be statistically insignificant. As such, there was no liver dysfunction in patients receiving AEDs as monotherapy or polytherapy.