Factors Influencing the Serum Concentration of Antiepileptic Drugs-Effects of Concomitant Antiepileptic Drugs on the Serum Valproic Acid Concentration in Epileptic Patients.

The study comprised 150 epileptic patients treated at the Institute of Neurology of the Clinical Centre Novi Sad. The optimal therapy with least adverse effects and seizures was achieved in patients in whom measurement of serum concentration of antiepileptic drugs was performed. Patients were divided into five groups with respect to the therapy they received: I - carbamazepine; II - valproic acid; III - polytherapy with phenobarbitone and diphenylhydantoin; IV - phenobarbitone and valproic acid; and V - phenobarbitone, valproic acid and carbamazepine. No adverse effects were recorded in over 60% of patients on monotherapy, 35% of patients who received two anticonvulsants, and 30% of patients who received three anticonvulsants. Significant correlation between drug dosage and blood drug concentration (r>0.5) was found in polytherapy with phenobarbitone, carbamazepine and valproic acid (r=0,66); and phenobarbitone and diphenylhydantoin (r=0,53).

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Plasma homocysteine and aminothiol levels in idiopathic epilepsy patients receiving antiepileptic drugs

Turkish Journal of Biochemistry ◽

10.1515/tjb-2018-0218 ◽

2019 ◽

Vol 44 (5) ◽

pp. 661-666

Author(s):

Dilber Çoban Ramazan ◽

Ülker Anadol ◽

A. Destina Yalçın ◽

A. Süha Yalçın

Keyword(s):

Valproic Acid ◽

Folic Acid ◽

Vitamin B12 ◽

Antiepileptic Drug ◽

Antiepileptic Drugs ◽

Serum Vitamin ◽

Idiopathic Epilepsy ◽

Serum Folate ◽

Significant Difference ◽

Epileptic Patients

Abstract Objective Homocysteine is a sulfur containing amino acid that is formed during methionine metabolism. Patients under long-term antiepileptic drug treatment often have hyperhomocysteinemia. These patients have low levels of serum folate, vitamin B12 and vitamin B6, all of which are associated with homocysteine metabolism. We have investigated the effects of valproic acid and new generation antiepileptic drugs (lamotrigine and levetiracetam) on plasma levels of homocysteine and aminothiols as well as serum vitamin B12 and folic acid. Materials and methods Forty-seven idiopathic epileptic patients on antiepileptic drugs were compared with 38 age-matched healthy controls. Commercial immunoassay methods were used for vitamin B12 and folic acid analyses. Homocysteine, cysteine, cysteinylglycine and glutathione levels were determined by high performance liquid chromatography. Results There was no significant difference in patient and control values in terms of vitamin B12, folic acid and homocysteine. Valproic acid and lamotrigine seemed to effect aminothiol redox status. Glutathione levels of epileptic patients receiving valproic acid and lamotrigine were higher than controls. Conclusion Our results suggest that redox homeostasis may be impaired and glutathione synthesis increased in response to the oxidative stress caused by antiepileptic drug use.

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