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Osteoporosis and epilepsy

These pages are about osteoporosis and epilepsy in the UK. If you are looking for information about osteoporosis and epilepsy in another country, please contact your local epilepsy organisation.

Some people who take epilepsy medicines are at risk of decreased bone mineral density. This information looks at why this happens, how you can protect your bones, and where you can find more information.

What is bone mineral density?

Bone mineral density (BMD) is a measure that shows the strength of your bones at a given time. Up to the age of 18 - 20 years, your bones increase in density and become stronger, bigger and heavier. This is possible by an ongoing process of growth and repair. By the time you reach middle-age, you will gradually lose bone strength, which could lead to a condition called osteoporosis. Osteoporosis is common in women over the age of 70, who take epilepsy medicines. If you have osteoporosis, your bones are more likely to break.

Am I at risk of having osteoporosis?

There are lots of different risk factors, including:

  • Reduced exposure to sunlight
  • Having an overactive thyroid gland
  • Having a family history of osteoporosis
  • Being a heavy drinker or smoker
  • Having taken epilepsy medicines for a long time

Some epilepsy medicines that can affect your bones

In 2009, the Medicines, Healthcare Products Regulatory Authority (MHRA) advised that people taking the following older epilepsy medicines long-term were at risk of osteoporosis or broken bones:

  • Carbamazepine
  • Phenytoin
  • Primidone
  • Sodium valproate

Phenobarbital can also affect bone health.

Some people take newer epilepsy medicines, such as oxcarbazepine (Trileptal), levetiracetam (Keppra) and gabapentin (Neurontin). Currently there is not enough information to tell us whether or not the newer epilepsy medicines affect bone mineral density.

If you are concerned about your epilepsy medicines affecting your bone health, speak to your doctor. Don’t stop taking your medicines, as this could cause you to have more seizures. 

Epilepsy Action has more information about epilepsy medicines

Can I check my osteoporosis risk?

The National Osteoporosis Society (NOS) has a [quiz] that you can use to assess your risk of developing osteoporosis. If your answers suggest you need to take measures to protect your bones, you will be given that information at the end of the quiz. You can also print a copy of your results to show your doctor. If you are at high risk of developing osteoporosis, your doctor may refer you for a bone density scan, known as a DEXA scan. This is brief and painless.

Managing and treating osteoporosis

Your doctor will look at all your risk factors, which will include how old you are, your sex, and the results of your DEXA scan. They might prescribe one of a number of different medicines and calcium and vitamin D supplements. See NHS Choices website for more information about treating osteoporosis: nhs.uk
You can watch a video on the NHS Choices website by Dr Pam Brown GP. Dr Brown explains about how you can keep your bones healthy.

Code: 
F039.04

Epilepsy Action would like to thank Dr Aza Abdulla, Consultant Physician, Princess Royal University Hospital, Bromley Hospitals NHS Trust, London for his contribution to this information.

Dr Abdulla has declared no conflict of interest.

This information has been produced under the terms of The Information Standard.

  • Updated August 2016
    To be reviewed August 2019

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Comments

I have osteopenia also sodium defects due to years of medication all different types through the years now for the last 9-10 year (may be incorrect of years) I am on Carbamazepine My Prof says my sodium level plays havoc with Carbamazepine or vice verse also my density from any Epilepsy tabs through the years long time so I have done high calcium diet for myself. I do not eat meat but eat a lot of oily fish. high calcium diet.

Submitted by Debs on