The effect of antiepileptic drugs on ischemia modified albumin, myeloperoxidase and catalase levels in children with idiopathic epilepsy

Objectives: The oxidant/antioxidant balance in epilepsy is regulated not only by seizures but also by antiepileptic drugs (AEDs). It has been shown that some AEDs in long-term use increase the formation of free radicals and cause oxidative damage within neuronal cells. However, antioxidant enzyme activities are found to be increased, decreased or unchanged in different studies. Aim To evaluate the effects of AEDs on the oxidant/antioxidant status by measuring catalase, myeloperoxidase and ischemia modified albümin (IMA) levels in pediatric epilepsy patients. Methods Ninety epilepsy patients without other comorbidities and 30 healthy children of similar age and gender were included. The patients were receiving AEDs for at least 6 months. They were divided into three groups: Group 1: patients receiving valproic acid (n=30), group 2: patients receiving carbamazepine (n=30) and group 3: patients receiving levetiracetam (n=30). Catalase, myeloperoxidase and IMA levels were measured in each group. Results IMA levels of patients receiving carbamazepine were significantly higher than the control group and the group receiving levetiracetam (p=0.010 and p=0.023, respectively). Myeloperoxidase level was significantly lower in the group receiving carbamazepine when compared with the control group (p=0.016). Conclusion The existing knowledge about the impact of AEDs on free radical/antioxidant system is poor and controversial. IMA is a marker of hypoxia and oxidative stress. This is the first study in which IMA was used to show the presence of oxidative stress related with AEDs and we determined that there was an increased oxidative stress in the carbamazepine group.
Keywords: Antiepileptic drugs, oxidative stress, ischemia modified albumin, myeloperoxidase, catalase