Heart Health and Seizure Meds: What You Need to Know

Epilepsy is a serious condition that affects many individuals, and antiseizure medications (ASMs) are commonly used to manage it. However, these medications can have unintended effects on the heart. Some ASMs can interfere with how the body processes fats, leading to an increased risk of heart disease. Others can directly affect the heart's electrical activity, potentially causing dangerous irregular heartbeats. This is especially true for certain types of ASMs that induce enzymes in the body, which can happen when these medications are taken at high doses or for extended periods. These changes in metabolism and heart rhythm can contribute to higher rates of heart problems and even death in people with epilepsy. The heart relies on a delicate balance of electrical signals to beat properly. Many ASMs can disrupt this balance by blocking sodium channels or altering the QT interval, which measures the heart's electrical cycle. This disruption can lead to dangerous heart rhythms, especially when these medications are combined with others or given to people who are already at risk. While it's rare for ASMs to directly cause heart arrhythmias, there's growing evidence that people with epilepsy might be more likely to experience these issues. Some cases of sudden cardiac death might even be mistaken for sudden unexpected death in epilepsy (SUDEP), making the true cardiovascular risk in this population unclear. It's also important to consider other factors that can increase heart disease risk, like smoking and a lack of physical activity. These habits are more common in people with epilepsy and can worsen the potential heart problems caused by ASMs. Understanding which ASMs have the most significant cardiovascular effects can help manage these risks. For instance, some ASMs are known to have more pronounced effects on the heart than others. This knowledge can guide doctors in choosing the right medication and monitoring patients more effectively. By working together, neurologists and cardiologists can provide better care and reduce the heart risks associated with epilepsy treatments.