Author

Dima M; Muhidien J; Al Akhras G.; Yaser S.

Published in

Journal of Laboratory Diagnosis, Volume 4, Issue 4, January 2007

Abstract

Epileptic patients receiving some Antiepileptic drugs (AEDs) like carbamazepine are at risk for folate and Vitamin B12 deficiency and elevated serum levels of homocysteine by hepatic enzyme induction (cytochrome P450). Data on valproate (VPA) effects on folic acid, Vitamin B12 and homocysteine are conflicting.

This study involved 187 subjects divided into 3 groups: control group 100 subjects (48 males and 52 females), epileptic patients treated with carbamazepine 47 subjects (22 males and 25 females), epileptic patients treated with valproate 40 subjects (18 males and 22 females).
The concentrations of serum Vit. B12, folate and homocysteine in male control groupe 309.6 pg/mL (SD = 64.4), 9.2 ng/mL (SD = 3.3), 13.18 µmol/L (SD = 2.2) respectively, and the concentrations of serum Vit. B12, folate and homocysteine in female control group 340.7 pg/mL (SD = 79.5), 9.4 ng/mL (SD = 3.3), 11.4 µmol/L (SD = 2.9) respectively.

The levels of serum Vit. B12 and folate were decreased significantly in male and female epileptic patients treated with carbamazepine (CBZ) compared with that in control groupe [249.9 pg/mL (SD = 89.4), 7.2 ng/mL (SD = 2.2), P < 0.05] and [285.9 pg/mL (SD = 103.7), 7.8 ng/mL (SD = 3.15), P < 0.05] respectively.

Our results showed that the levels of serum homocysteine were increased significantly in male and female epileptic patients treated with carbamazepine (CBZ) compared with that in control groupe [17.6 µmol/L (SD = 6.1), 13.7 µmol/L (SD = 6.7), P < 0.05] respectively.

There were no significant differences in the serum levels of Vit. B12, folate and homocysteine between male and female epileptic patients treated with valproate (VPA) and control groupe [342.5 pg/mL (SD = 69.1), 9.9 ng/mL (SD = 2.6), 12.9 µmol/L (SD = 4.3) P > 0.05] and [364.9 pg/mL (SD = 56.8), 10.5 ng/mL (SD = 3.2), 10.4 µmol/L (SD = 3.1), P > 0.05] respectively.

We found that the levels of serum Vit. B12 and folate were decreased and the levels of serum homocysteine were increased significantly in male and female epileptic patients treated with carbamazepine (CBZ) compared with that in male and female epileptic patients treated with valproate (VPA), (P < 0.05).

Our results may be explainable by the different biotransformation pathway of (AEDs), CBZ induces and VPA inhibits cytochrome P450. This may explaine why the Vit.amin status differs between the two antiepileptics.

Link to read full paper

http://scla.org.sy/magazine/issues/4_4/156.html