The Faculty of Pharmacy discussed the Master’s Degree thesis, tagged” Comparative Study of the Effect of First and Second Generation of Antiepileptic Drugs on the Development of Bone Disorders in Iraqi Epilepsy” by Sara Jafer Mohammed and the supervisor, Professor Dr. Shatha Hussein Ali in the Clinical Laboratory Sciences/Clinical Chemistry Department. The thesis aimed to evaluate the effects of chronic treatment with a first-generation antiepileptic drug (Carbamazepine or Valproate) compared to a second-generation antiepileptic drug (Levetiracetam) on the development of bone-related disorders in Iraqi adult epileptic patients by measuring some serum biomarkers related to bone metabolism, including calcium (Ca⁺²), inorganic phosphate (PO₄ˉᶾ), bone alkaline phosphatase (BAP) activity, Parathyroid hormone (PTH), Vitamin D2 (VD2) and osteoprotegerin (OPG) levels. The concept of the thesis Data analysis revealed the value of serum parathyroid hormone levels was significantly elevated in the epileptic patient groups compared to the healthy control group. However, group 2 (the first generation of antiepileptic drug) was presented with higher values. Serum calcium and inorganic phosphate levels showed non-significant variation for all the studied groups .Furthermore, serum bone alkaline phosphatase activity was significantly higher in patients compared to healthy subjects, with a greater increase among those on first-generation antiepileptic drugs (Carbamazepine or Valproate). The vitamin D2 levels were not significantly different between both types of antiepileptic drugs, with lower values than the control group. Furthermore, serum osteoprotegerin levels were significantly elevated in group 1 compared to group 2. However, both of the epileptic patient groups had significantly higher values than the healthy subject group. The epileptic adults on antiepileptic drugs (AEDs) for more than two years had higher parathyroid hormone levels, with greater values than those on the second generation of antiepileptic drug, (levetiracetam) . There were no significant differences between the first generation of antiepileptic drugs Carbamazepine or Valproate and the second generation of antiepileptic drugs (Levetiracetam) considering serum vitamin D2 concentrations. Higher serum osteoprotegerin levels in epileptic patients on first generation of antiepileptic drug compared to those on second generation of antiepileptic drug; group-1 was significantly higher than the healthy control group. In addition, serum Bone alkaline phosphatase activity levels were significantly elevated in epileptic patients (group-1 and group-2) compared to the healthy control subjects, with higher values produced by the first generation of antiepileptic drug. Meanwhile, serum inorganic phosphate levels expressed a significant negative correlation with bone alkaline phosphatase activity on the second generation of antiepileptic drug. The necessity for patients on long-term antiepileptic drugs who are at risk of bone disorders to take vitamin D3 capsules at a dose of 50000 I.U. weekly for three months to prevent future bone disorders and their effects on the frequency and severity of seizures. It is essential for patients with epilepsy and a family history of epilepsy to go for a check-up such as a CBC, blood tests, a neurological examination, an EEG, (CT) scan, and an MRI once every three months to prevent seizures.
