Which precaution is recommended when long-term antiseizure therapy may impact bone health?

• A. Monitor bone health, ensure adequate calcium/vitamin D, and promote weight-bearing activity
• B. Discontinue antiseizure therapy to protect bones
• C. Increase caffeine intake
• D. Avoid exercise completely

Answer: (A)

Long-term antiseizure medications can affect bone health by altering vitamin D metabolism and bone turnover, which can raise the risk of osteoporosis and fractures. The best precaution is to actively support bone health: monitor bone health with appropriate tests when needed, ensure adequate calcium and vitamin D intake, and engage in weight-bearing activities that stimulate bone formation. Regular screening helps catch bone loss early, supplements support mineralization, and weight-bearing exercise—like walking, light resistance training, or stair climbing—helps maintain bone density and reduces fracture risk.

Discontinuing therapy isn’t a practical solution because seizure control is crucial and stopping medication can lead to seizures. Increasing caffeine intake isn’t protective for bones and may negatively affect calcium balance. Avoiding exercise weakens bones and increases fracture risk, so staying active with appropriate guidance is beneficial.