Adults taking antiepileptic drugs (AEDs) have an augmented risk for osteopenia and
osteoporosis because of abnormalities of bone metabolism associated with AEDs. The
increased fracture rates that have been described among patients with epilepsy may be
related both to seizures and to AEDs. The hepatic enzyme–inducing AEDs phenytoin,
phenobarbital, and primidone have the clearest association with decreased bone mineral
density (BMD). Carbamazepine, also an enzyme-inducing drug, and valproate, an enzyme …