چکیده (انگلیسی):

This study was conducted to assess the effect of carbamazepine, sodium valproate and
phenytoin on serum liver enzymes in 49 epileptic patients admitted to the neurology
outpatient clinic at Beni-Suef University between February 2010 and June 2011. The patients
were separated into group I (16 patients) treated with 200e1200 mg/day carbamazepine;
group II (16 patients) treated with 200e800 mg/day sodium valproate; and group III
(17 patients) treated with 200e400 mg/day phenytoin. Serum liver enzymes aspartate
aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and
serum level of antiepileptic drug were determined. No patient developed clinical symptoms
of liver disease. Hepatic enzymes abnormal values were seen in 51.9% (n ¼ 27) in the three
study groups. In group I, the alterations at ALP enzyme were 50% (n ¼ 8). In group II, the
alterations at ALT were 6.25% (n ¼ 1) and at ALP were 62.5% (n ¼ 10). In group III, the alterations
at AST were 5.88% (n ¼ 1), at ALT were 17.65% (n ¼ 3) and at ALP were 23.53%
(n ¼ 4). There was a statistically significant positive correlation between the dose/kg of
carbamazepine and the serum level of the drug, a statistically significant positive correlation
between the dose/kg of sodium valproate and AST and a statistically significant
negative correlation between the duration of administration of sodium valproate and AST.
There was also a statistically significant negative correlation between the duration of
administration of carbamazepine and AST and ALP. In conclusion, sodium valproate was
more hepatotoxic than carbamazepine which was more hepatotoxic than phenytoin. The
routine screening of hepatic enzymes level during the chronic use of antiepileptic drugs is
recommended.