Hamed Sherifa Ahmed
Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University Hospital, Floor # 4, Room # 4, P.O.Box 71516, Assiut, Egypt.
Expert Rev Clin Pharmacol. 2015 Jan;8(1):103-14. doi: 10.1586/17512433.2015.991716.
Data from clinical trials, retrospective and cross-sectional studies have quantified the metabolic changes associated with long-term use of antiepileptic drugs (AEDs). AEDs can be associated with weight gain or weight loss, although most are weight neutral. Weight gain is not only a cosmetic problem but also a risk for obesity-related vascular disorders. Weight loss may compromise growth in children/adolescents. This review discusses the possible contribution of peripheral and central hormones/neuropeptides (as leptin, insulin, adiponectin, neuropeptide-Y, ghrelin and galanin) and pathways that influence energy balance in the pathogenesis of weight changes with AEDs. As AEDs may influence weight, physicians have to properly select and characterize the suitable AED as an initial step or modify the existing AED if it compromises patient's health.
来自临床试验、回顾性研究和横断面研究的数据已经量化了与长期使用抗癫痫药物(AEDs)相关的代谢变化。AEDs可能与体重增加或体重减轻有关,尽管大多数对体重没有影响。体重增加不仅是一个美容问题,也是肥胖相关血管疾病的一个风险因素。体重减轻可能会影响儿童/青少年的生长发育。这篇综述讨论了外周和中枢激素/神经肽(如瘦素、胰岛素、脂联素、神经肽Y、胃饥饿素和甘丙肽)以及影响能量平衡的途径在AEDs所致体重变化发病机制中的可能作用。由于AEDs可能影响体重,医生必须作为第一步正确选择并确定合适的AED,或者如果现有AED损害患者健康则对其进行调整。