Drug link to bone disease ignored by neurologists

The majority of neurologists in a recent survey admit that they do little to protect the bones of patients taking antiepileptic drugs (AEDs).

AEDs, such as phenobarbital, phenytoin and carbamazepine, can lead to vitamin D deficiency and bone disease. However, this can be treated and prevented with calcium and vitamin D supplements. But the 404 paediatric and 624 adult neurologists questioned in this survey, conducted by researchers at Sinai Hospital of Baltimore in Maryland, claimed not to believe that AED-related bone disease has any clinical importance. As a result, few (7 and 9 per cent of adult and paediatric neurologists, respectively) administer prophylactic calcium and vitamin D to patients taking AEDs.

Only 28 per cent of the adult neurologists and 41 per cent of the paediatric neurologists routinely evaluate AED patients for bone and mineral disease. Even when bone disease is detected, only 37 per cent of adult and 40 per cent of paediatric specialists prescribed calcium or vitamin D (Arch Neurol, 2001; 58: 1369-74).