Early effect of sodium valproate and carbamazepine monotherapy on homocysteine metabolism in children with epilepsy

Attilakos, Achilleas; Papakonstantinou, Evangelos; Schulpis, Kleopatra H.; Voudris, Konstantinos; Katsarou, Eustathia; Mastroyianni, Sotiria; Garoufi, Anastasia

doi:10.1016/j.eplepsyres.2006.06.015

Cited by 45 publications

(50 citation statements)

References 14 publications

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“…In addition, sample sizes were small, and data are lacking for most of the newer AED. [10][11][12][13][14] Thus, valid and detailed data on the association of the commonly used AED with folate and vitamin B12 serum levels are missing.…”

Section: Objectivementioning

confidence: 99%

Antiepileptic drugs interact with folate and vitamin B12 serum levels

Linnebank

Moskau

Semmler

et al. 2011

Annals of Neurology

123

102

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OBJECTIVE: Antiepileptic drugs (AEDs) are important for the treatment of epilepsy, psychiatric diseases, and pain syndromes. Small studies have suggested that AED treatment reduces serum levels of folate and vitamin B12. METHODS: This prospective monocenter study aimed at testing the hypothesis that AED treatment is associated with folate and vitamin B12 serum levels in a large population. A total of 2730 AED-treated and 170 untreated patients with epilepsy and 200 healthy individuals were enrolled. RESULTS: Treatment with carbamazepine, gabapentin, oxcarbazepine, phenytoin, primidone, or valproate was associated with lower mean serum folate levels or with a higher frequency of folate levels below the reference range in comparison with the entire group of patients, untreated patients, or controls. Treatment with phenobarbital, pregabalin, primidone, or topiramate was associated with lower vitamin B12 levels compared with the entire group of patients. Vitamin B12 serum levels were higher in patients treated with valproate compared with the entire group of patients, untreated patients, and healthy controls. Folate or vitamin B12 levels below the reference range were associated with higher mean corpuscular volume (MCV) and higher homocysteine plasma levels. Vitamin substitution for 3 months in 141 patients with folate or vitamin B12 levels below the reference range yielded normal vitamin levels in 95% of the supplemented patients and reduced MCV and homocysteine plasma levels. INTERPRE-TATION: Treatment with most of the commonly used AEDs is associated with reduced folate or vitamin B12 serum levels and is a risk factor for hyperhomocysteinemia. Oral substitution is effective to restore vitamin, MCV, and homocysteine levels.

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Section: Objectivementioning

confidence: 99%

Antiepileptic drugs interact with folate and vitamin B12 serum levels

Linnebank

Moskau

Semmler

et al. 2011

Annals of Neurology

123

102

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“…When PHT-and CBZ-treated patients were considered as separate groups and compared to normal subjects, the incidence of The major result of the present investigation was the finding that B6 deficiency is very common in the inducer-treated population, and in most cases was improved by switch to a noninducer. Several studies have found reduced B6 levels in CBZ-treated patients, and in two of the studies this could clearly be attributed to CBZ [2,4,9]. However, none of these studies reported the incidence of B6 deficiency, so that the clinical relevance of these changes, other than their potential contribution to homocysteine deficiency, remained uncertain.…”

Section: Resultsmentioning

confidence: 95%

B-Vitamin deficiency in patients treated with antiepileptic drugs

Mintzer

Skidmore

Sperling

2012

Epilepsy & Behavior

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“…Although reports have remained controversial, several studies have also suggested decreased vitamin B6 plasma levels in association with treatment with carbamazepine n = 20 patients (Attilakos, et al 2006), n = 19 (Sener, et al 2006), n = 28 (Verrotti, et al 2000), n = 20 (Tamura, et al 2000), phenytoin n = 20 (Tamura, et al 2000), valproate n = 13 (Tamura, et al 2000), n = 32 (Verrotti, et al 2000) or with any AED treatment n = 101 (Apeland, et al 2003), n = 500 (Krause, et al 1988), n = 51 (Schwaninger, et al 1999), n = 59 (Vilaseca, et al 2000). Major et al suggested that substitution of vitamin B6 lowered behavioral side effects of levetiracetam in 42 pediatric patients (Major, et al 2008).…”

Section: Objectivementioning

confidence: 99%

Antiepileptic drugs and vitamin B6 plasma levels in adult patients

et al. 2012

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Treatment with several antiepileptic drugs (AED) is associated with lower serum concentrations of folate or vitamin B12. This prospective monocenter study analyzed vitamin B6 blood levels in 400 serial patients with epilepsy, AED-treated (n=385), untreated (n=15) and healthy controls (n=233). The mean plasma vitamin B6 levels of the AED-treated (12.1±10.1; p=0.093) and the untreated patients (15.6±12.4; p=0.664) were not significantly different from the controls (13.9±15.2). These observations do not support the hypothesis that vitamin B6 blood levels are influenced by AED treatment.

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Early effect of sodium valproate and carbamazepine monotherapy on homocysteine metabolism in children with epilepsy

Cited by 45 publications

References 14 publications

Antiepileptic drugs interact with folate and vitamin B12 serum levels

Antiepileptic drugs interact with folate and vitamin B12 serum levels

B-Vitamin deficiency in patients treated with antiepileptic drugs

Antiepileptic drugs and vitamin B6 plasma levels in adult patients

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