Ammonia and carnitine concentrations in children treated with sodium valproate compared with other anticonvulsant drugs.
Plasma ammonia was measured in 59 children requiring anticonvulsant drugs: 37 children (group 1) on sodium valproate alone or in combination with other drugs and 22 children (group 2) on drugs other than sodium valproate. Plasma ammonia was higher in group 1 children. Total and free carnitine was measured in plasma and erythrocytes of all children and in the urine of 16 children from group 1 and eight from group 2. Plasma and erythrocyte free carnitine was significantly lower in the children on sodium valproate, along with a significant increase in the ratio of acyl (bound) carnitine to free carnitine. No significant correlation was found between plasma ammonia and carnitine concentrations for either group of children. Plasma and erythrocyte concentrations were not related. Urinary free carnitine was reduced in children treated with valproate, with a significant increase in the ratio of bound to free carnitine. Carnitine supplementation is discussed.
Thom
H
H
Department of Child Health, University of Aberdeen, Medical School, Foresterhill.
Carter
P E
PE
Cole
G F
GF
Stevenson
K L
KL
D000293:Adolescent; D000641:Ammonia / Q000097:blood*; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D002331:Carnitine / Q000097:blood* / Q000172:deficiency; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy*; D004912:Erythrocytes / Q000187:drug effects / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use
D000927:Anticonvulsants; D014635:Valproic Acid; D000641:Ammonia; D002331:Carnitine