Side Effects of Different Enzyme-Inducing Anti-Seizure Medications on Lipid Profile in Patients With Epilepsy: A Systematic Review and Meta-Analysis Publisher



Davari A ; Zafari R ; Bahadori AR ; Mohammadiasl A ; Sheikhvatan M ; Tafakhori A ; Shafiee S ; Ranji S
Source: Neurology and Clinical Neuroscience Published:2026

Abstract

Anti-seizure medications (ASMs) may influence lipid profiles, potentially increasing the risk of cardiovascular diseases. A systematic review and meta-analysis was conducted following PRISMA guidelines. Five databases were searched up to October 2024. Statistical analysis was performed using fixed and random-effects models in Comprehensive Meta-analysis software (CMA). Of the 22 studies included in the systematic review, 17 of them ran for meta-analysis. Treatment with enzyme-inducing ASMs, particularly carbamazepine (CBZ) and phenytoin (PHT), was associated with significantly higher lipid parameters compared with healthy controls, including LDL-C (CBZ: SMD = 0.70, p = 0.01; PHT: SMD = 0.80, p < 0.001), total cholesterol (CBZ: SMD = 0.62, p < 0.01; PHT: SMD = 0.69, p = 0.045), and triglycerides (CBZ: SMD = 0.35, p < 0.01). Differences observed between enzyme-inducing ASMs and non-enzyme-inducing agents such as lamotrigine were derived from indirect comparisons across studies. Our findings suggest that carbamazepine and phenytoin may increase lipid profiles. Further research is needed to confirm these findings and explore long-term impacts. © 2026 Japanese Society of Neurology and John Wiley & Sons Australia, Ltd.