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Hypercupraemia Induced by Antiepileptic Drugs

Lingfield Hospital School, Lingfield, Surrey

A. Taylor

Robens Institute, University of Surrey, Guildford

1 Serum copper and zinc levels were measured in 84 treated male epileptics, aged between 6 and 18 years, by an atomic absorption spectroscopic method. These patients were selected randomly from a residential special school. Twenty drug-free healthy but educationally subnormal (ESN) male subjects of similar age group from the same school acted as controls.

2 No abnormality in serum zinc level was observed.

3 In nineteen (22.6%) epileptics, copper levels were above the upper level of normal range (20.5 µmol/l), whereas this was only marginally elevated (20.8 µmol/l) in one (5%) ESN subject.

4 The mean copper level in all epileptics was higher than the controls (P<0.01), but there was no difference between the epileptics treated with sodium valproate alone and the ESN group.

5 The patients who were receiving carbamazepine either as monotherapy or in combination with other drugs except phenytoin, had higher mean copper levels than the controls (P<0.01). A similar observation was made in relation with phenytoin polytherapy (but excluding carbamazepine).

6 There also appeared to be an association between the high serum copper levels and diffuse/generalized electroencephalographic changes (P < 0.001). Some antiepileptic drugs, particularly carbamazepine, can produce such electroencephalographic abnormalities.

7 It is concluded that hypercupraemia observed in these treated epileptics were related to the induction of caeruloplasmin synthesis by phenytoin and carbamazepine.

Human & Experimental Toxicology, Vol. 2, No. 3, 519-529 (1983)
DOI: 10.1177/096032718300200308


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