T Apeland1, M A Mansoor, R E Strandjord, H Vefring, O Kristensen. 1. Department of Internal Medicine, Department of Clinical Chemistry and Stavanger Neurological Unit, Rogaland Central Hospital, Stavanger, Norway. apeland@online.no
Abstract
OBJECTIVES: Some antiepileptic drugs (AEDs) are associated with low levels of serum (S-FA) and erythrocyte folate (E-FA) and high levels of plasma total homocysteine (p-tHcy). We have explored the concentrations of S-FA, E-FA and p-tHcy in patients on carbamazepine (CBZ). The methionine loading test was applied for better assessment of mildly impaired homocysteine metabolism. MATERIAL AND METHODS: The study comprised 42 adult patients on CBZ and 42 matched healthy controls. Blood samples were drawn prior to and 6 h post methionine loading (6 h-PML) (0.1 g/kg body weight). RESULTS: The patients on CBZ had significantly lower concentrations of fasting S-FA and E-FA than the controls (P=0.0004, P=0.003, respectively). Fasting and 6 h-PML p-tHcy concentrations were significantly higher in the patients than in the controls (P=0.03 and P=0.0001, respectively). The methionine loading test identified additional patients with hyperhomocysteinemia undetected by fasting p-tHcy. CONCLUSION: CBZ therapy may be associated with low folate and high p-tHcy levels.
OBJECTIVES: Some antiepileptic drugs (AEDs) are associated with low levels of serum (S-FA) and erythrocyte folate (E-FA) and high levels of plasma total homocysteine (p-tHcy). We have explored the concentrations of S-FA, E-FA and p-tHcy in patients on carbamazepine (CBZ). The methionine loading test was applied for better assessment of mildly impaired homocysteine metabolism. MATERIAL AND METHODS: The study comprised 42 adult patients on CBZ and 42 matched healthy controls. Blood samples were drawn prior to and 6 h post methionine loading (6 h-PML) (0.1 g/kg body weight). RESULTS: The patients on CBZ had significantly lower concentrations of fasting S-FA and E-FA than the controls (P=0.0004, P=0.003, respectively). Fasting and 6 h-PMLp-tHcy concentrations were significantly higher in the patients than in the controls (P=0.03 and P=0.0001, respectively). The methionine loading test identified additional patients with hyperhomocysteinemia undetected by fasting p-tHcy. CONCLUSION:CBZ therapy may be associated with low folate and high p-tHcy levels.
Authors: Bruce Hermann; Michael Seidenberg; Mark Sager; Cynthia Carlsson; Barry Gidal; Raj Sheth; Paul Rutecki; Sanjay Asthana Journal: Epilepsia Date: 2007-11-21 Impact factor: 5.864
Authors: Elisabetta Patorno; Robert J Glynn; Sonia Hernandez-Diaz; Jerry Avorn; Peter M Wahl; Rhonda L Bohn; Daniel Mines; Jun Liu; Sebastian Schneeweiss Journal: J Am Heart Assoc Date: 2013-07-30 Impact factor: 5.501