Valproate, Carnitine Metabolism, and Biochemical Indicators of Liver Function

Beghi, Ettore; Bizzi, A.; Codegoni, Anna Maria; Trevisan, Daniela; Torri, Valter

doi:10.1111/j.1528-1157.1990.tb05387.x

Cited by 59 publications

(21 citation statements)

References 42 publications

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“…Our results agree with those of most authors finding increased HDL cholesterol levels in patients receiving AEDs (14)(15)(16)(17)(18)(19)(20)(21)(22), with the exception of carbamazepine monotherapy, as reported by Luoma et al (14).…”

Section: Discussionsupporting

confidence: 80%

Physical Activity, Heath‐Related Fitness, and Health Experience in Adults with Childhood‐Onset Epilepsy: A Controlled Study

Jalava

Sillanpää

1997

Epilepsia

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Summary: Purpose: To show any possible associations between childhood-onset epilepsy and physical activity, health-related fitness, and health experience.Methods: A population-based cohort of 176 patients with epilepsy since childhood was monitored for a mean of 35 years. Patients with recurrent, unprovoked epileptic seizures with no associated initial neurologic impairment or disability, termed those with "epilepsy only" (n = loo), were compared with matched controls for self-reported physical activity, health experience, laboratory tests, body mass index, and muscle power tests.Results: On the basis of muscle tests, physical fitness proved to be significantly poorer in patients with "epilepsy only" than in matched controls. During the preceding year, 22% of patients and 24% of controls had reduced their physical activities because of some illness; only 2% reduced their physical activities because of epilepsy. No significant ~~ difference was found in blood status, except for a lower serum creatinine level in the patients. Current antiepileptic drug (AED) therapy appeared significantly associated with lower hemoglobin and creatinine levels and higher highdensity lipoprotein values. The patients perceived their health status to be comparable with that of controls, irrespective of physical inactivity, continued seizures, or AED monotherapy. However, patients receiving AED polytherapy perceived their health as rather poor or very poor significantly more often than did controls.Conclusions: Based on objective muscle tests, adults with childhood-onset "epilepsy only" have poorer physical fitness than do matched controls, but they have a feeling of good personal health.

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Section: Discussionsupporting

confidence: 80%

Physical Activity, Heath‐Related Fitness, and Health Experience in Adults with Childhood‐Onset Epilepsy: A Controlled Study

Jalava

Sillanpää

1997

Epilepsia

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“…This is supported by the finding of Beghi et al [25] . In addition, a significant increase of the mean values of GOT in the sera of phenytoin treated cases (P < 0.001) and GPT in the sera of phenobarbital treated cases (P < 0.05) after, in comparison to that before therapy.…”

Section: Discussionsupporting

confidence: 79%

“…Previous reports of Morita et al [24] , Segade et al [18] , and Beghi et al [25] support these findings. In the study of Segade et al [18] , they found that the groups treated with carbamazepine and phenobarbital had free carnitine concentration less than those of controls.…”

Section: Discussionmentioning

confidence: 59%

“…They detected hypocarnitinemia in 21.5% of their studied patients. In the study of Beghi et al [25] , they reported that carnitine deficiency, which is produced with these antiepileptic drugs, is worth noting and may be a part of a more general biochemical effect of antiepileptic drug therapy on lipid metabolism. However, the significant hypocarnitinemia found in the present study was not detected in the study of Ohtani et al [6] and Sugimoto et al [11] .…”

Section: Discussionmentioning

confidence: 99%

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Carnitine and Liver Functions Assessment in ChildrenTreated with Anticonvulsant Drugs

Abdel-Ghany¹,

Saleem²,

Ghazaly³

et al. 2000

med

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ABSTRACT. This study was conducted to evaluate the impact of antiepileptic drugs on the liver function and L-carnitine levels in children suffering from epilepsy. Sixty epileptic children aged from 1 to 15 years, together with 20 healthy controls were studied. Among them twenty-five children were treated with phenytoin (group I), 25 were treated with carbamazepine (group II) and 10 patients were treated with phenobarbital (group III). In each of the three groups, serum free carnitine levels were significantly decreased after one month of therapy compared with pretherapy levels (p<0.01, p<0.01, p<0.01 respectively). Meanwhile, the levels of L-carnitine in treated children collectively were significantly decreased in comparison with healthy children (p<0.01). Hypocarnitinemia was detected in 28% of group I, 56% of group II , and 30% of group III. Serum SGOT was significantly increased in patients treated with phenytoin and phenobarbital (p<0.01, p<0.05 respectively) compared with pretherapy levels. Whereas serum lactate and total bilirubin were significantly increased after therapy in patients treated with carbamazepine in comparison to that before significantly increased (p<0.05 for each) in comparison with controls. Moreover, a significant negative correlation was found between values of carnitine and both lactate (p<0.01) and lactate/pyruvate ratio (p<0.05) after therapy in carbamazepine treated group. It should be taken into account that carnitine rich food in the form of milk and milk products must be taken as a supplement to the antiepileptic drugs especially carbamazepine.

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“…Though it is well known that the clinical measurement of serum ammonia levels can be helpful in diagnosis of valproate toxicity, the correlation between serum ammonia and valproate during valproate toxicity is not clear. Studies done to find out the correlation between serum ammonia and AEDs had contradictory reports (12,13). Ettora et al found a significant correlation between serum ammonia and AEDs, mostly valproate, which was in contrast to the findings of Laub et al who found no such correlation.…”

Section: Resultsmentioning

confidence: 92%

Hyperammonemia and hepatic status during valproate therapy

Agarwal

Sharma

Chhillar

et al. 2009

Indian J Clin Biochem

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The present study was conducted to assess correlation of ammonia levels with valproate levels in epileptic patients presenting with valproate toxicity and also whether liver enzymes and ammonia levels could serve as biochemical marker of valproate toxicity. 100 patients with epilepsy who had received valproate therapy for more than 12 months and had presented with valproate toxicity and 100 controls were included in the study. The serum valproate, ammonia and liver enzymes were measured in these subjects. In patients with valproate toxicity, the mean level of serum valproate was 110.91 ± 28.68 mg/dL (therapeutic range 50-100 mg/dL). Serum ammonia was higher (86.37 ± 39.90 µg/dL) in patients with valproate toxicity compared to controls (68.73 ± 30.07 µg/dL). Out of 100 patients, only 37 patients had serum valproate level > 120 mg/dL and 22 patients had raised levels of valproate as well as ammonia. Age < 30 years and serum ammonia > 69 μg/dL is risk factors for valproate toxicity. Serum ammonia, liver enzymes should be regularly investigated in patients on valproate therapy for early diagnosis of valproate toxicity.

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Valproate, Carnitine Metabolism, and Biochemical Indicators of Liver Function

Cited by 59 publications

References 42 publications

Physical Activity, Heath‐Related Fitness, and Health Experience in Adults with Childhood‐Onset Epilepsy: A Controlled Study

Physical Activity, Heath‐Related Fitness, and Health Experience in Adults with Childhood‐Onset Epilepsy: A Controlled Study

Carnitine and Liver Functions Assessment in ChildrenTreated with Anticonvulsant Drugs

Hyperammonemia and hepatic status during valproate therapy

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