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KMID : 0350519960490010387
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Journal of Catholic Medical College
1996 Volume.49 No. 1 p.387 ~ p.395
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The Effects of Antiepileptic Drugs on Serum and Red Cell Folate in Epileptic Children
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Abstract
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To assess the effect of antiepileptic drugs (AEDs) 0n blood folate, we evaluated the serum and red cell folate levels by means of competitive. Radioassay as well as the peripheral blood findings in epileptic children treated with various AEDs.
This study included a control group of 24 children (13 males, 11 females : 6-16 years of age) and 56 epileptic patients (32 males, 24 females : 6-20 years of age) who were divided into four AED-treated groups : phenobarbital (PB) monotherapy
(n=9),
carbamazepine (CBZ) monotherpy (n=22), valproic acid (VPA) monotherapy (n=11) and CBZ polytherapy (n=14).
@ES The results were as follows:
@EN 1. The red cell folate levels were significantly reduced in the patient group compared with the control group, but serum folate levels were statistically insignificant.
2. The number of patient whose red cell folate level reduced by up to 2 SD below the mean of control group was 11 of 56 patients in AED-treated group : 3 of 9 in PB monotherapy (33.3%), 6 of 22 in CBZ monotherapy (27.3%), 1 of 11 in VPA
monotherapy
(9.1%), and 1 of 14 in CBZ polytherapy (7.1%).
3. From the peripheral blood studies, only the value of mean corpuscular volume (MCV) was significantly increased in the patient group compared with the control group.
4. The number of patients whose MCV value increased group : 4 of 9 in PB monotherapy (44.4%), 3 of 22 in CBZ monotherapy (13.6%), 1 of 11 in VPA monotherapy (9.1%), and 5 of 14 in CBZ polytherapy (35.7%).
5. The reduced levels of red cell foltate and the increased values of MCV were obsedrved in PB monotherapy, CBZ monotherapy , and CBZ polytherapy, but not in VPA monotherapy group.
6. There was neither correlation between the reduced levels of red cell folate and the increased values of MCV nor between the duration of AEDs therapy and the reduced levels of red cell folate or the increased values of MCV.
It is suggested that the reduction ofr red cell folate levels should be considered in epileptic patients treated with PB or CBZ, although the clinical symptoms of folate deficiency were not found in patients of this study, and that the
measurement
of
red cell foltae may be a useful parameter to detect the disturbance of folic acid metabolism in its early stage.
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