Farmaci antiepilettici, vitamina D e mineralizzazione ossea: le evidenze e le azioni

Abstract

The possible negative effects of antiepileptic drugs on bone metabolism with the consequent possible risks have been discussed in the literature for more than 30 years. Two reviews of the literature attempted to answer the following clinical questions: “Should vitamin D supplementation be used in children receiving antiepileptic drugs?”, “Do children on chronic antiepileptic drug therapy have to perform bone densitometry (DEXA) to assess the state of bone mineralization”? The evidence suggests to prescribe a prophylaxis with vitamin D at 400 IU/day to children on antiepileptic therapy and without other risk factors and provide them with indications regarding correct eating, motor and sun exposure lifestyles. Higher doses will be evaluated in case of coexistence of risk factors. DEXA screening may be useful in children on antiepileptic therapy and with a history of fractures (particularly multiple or low impact fractures) or in children on prolonged antiepileptic therapy and in the presence of additional risk factors (e.g. infantile cerebral palsy).