Evaluation of Antioxidant Effects of Antiepileptic Drugs in Adult Epileptic Patients: An Open Label, Non Randomised Interventional Study

Abstract

Introduction: Oxidative stress is one of the factors implicated in the pathogenesis of epilepsy. Various antiepileptic drugs can control seizures by several mechanisms that may involve reduction of oxidative stress. Only a few studies have evaluated the antioxidant effects of Antiepileptic Drugs (AEDs). Aim: To evaluate the antioxidant activity of the AEDs (Phenytoin, Levetiracetam, Oxcarbazepine) in adult epileptic patients. Materials and Methods: The present open label, non randomised interventional study was conducted at the tertiary care hospital, Hyderabad, Telangana, India, from September 2016 to November 2017. Total of 45 subjects were divided into three groups, Phenytoin group, Levetiracetam group and Oxcarbazepine group with 15 patients in each group. Blood samples were collected prior to initiation of treatment and after three months of treatment for measurement of antioxidative parameters such as Malondialdehyde (MDA), Nitric Oxide (NO) and reduced Glutathione (GSH) levels. Paired t-test was used for within group analysis. Results: Amongst the total subjects of 45,(15 in each group), 14 subjects in phenytoin group, 12 in Levetiracetam group and 13 in oxcarbazepine group were finally analysed. The mean age was 28.92±9.62 years, mean weight was 55.87±10.73 kg and mean Body Mass Index (BMI) was 21.99±3.82 kg/m2. No statistically significant difference was seen in all oxidative parameters in phenytoin treated group. In levetiracetam group, significant decrease in MDA levels (p-value- 0.0338) and increase in GSH levels (p-value <0.0001) was observed after three months of treatment. In oxcarbazepine group, statistically significant decrease was found in MDA (p-value-0.0055) and NO levels (p-value-0.016) and increase in GSH levels (p-value- 0.0004) was observed. Conclusion: It was concluded that phenytoin has no role in reducing oxidative stress in epileptic patients, whereas levetiracetam decreases lipid peroxidation and oxcarbazepine has beneficial role in reducing oxidative stress in adult epileptic patients.

Keywords

• levetiracetam
• malondialdehyde
• nitric oxide
• oxcarbazepine
• phenytoin
• reduced glutathione