Effects of add-on melatonin administration on antioxidant enzymes in children with epilepsy taking carbamazepine monotherapy: a randomized, double-blind, placebo-controlled trial.
OBJECTIVE
Melatonin has been shown to exhibit antioxidant, antiexcitotoxic, and free radical-scavenging properties in various animal models. The study was designed to assess its effects on the blood levels of antioxidant enzymes in children with epilepsy receiving carbamazepine (CBZ).


METHODS
In a double-blind, randomized, parallel-group, placebo-controlled trial, we assessed the effect of add-on melatonin (6-9 mg/day for 14 days) on the antioxidant enzymes glutathione peroxidase (GPx) and glutathione reductase (GRd) in 31 children with epilepsy receiving CBZ monotherapy, who were seizure free at least for the last 6 months. The interaction of melatonin with CBZ and its active metabolite, carbamazepine-10, 11-epoxide (CBZ-E), also was studied.


RESULTS
An increase in GRd activity was noted in the melatonin group as compared with a decrease of the same enzyme in the placebo group. Changes in GPx activity failed to reach statistical significance. No significant changes were found in the serum levels of CBZ and CBZ-E in either group.


CONCLUSIONS
The study suggests that melatonin exerts antioxidant activity in patients with epilepsy receiving CBZ therapy.
Gupta
Madhur
M
Department of Pharmacology, Lady Hardinge Medical College & Associated Hospitals, New Delhi, India. madhurgupta@hotmail.com
Gupta
Yogendra Kumar
YK
Agarwal
Sarita
S
Aneja
Satinder
S
Kalaivani
Mani
M
Kohli
Kamlesh
K
D000927:Anticonvulsants / Q000627:therapeutic use*; D000975:Antioxidants / Q000378:metabolism*; D002220:Carbamazepine / Q000031:analogs & derivatives* / Q000097:blood / Q000378:metabolism / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000188:drug therapy* / Q000201:enzymology*; D005260:Female; D005979:Glutathione Peroxidase / Q000097:blood* / Q000187:drug effects; D005980:Glutathione Reductase / Q000097:blood* / Q000187:drug effects; D006801:Humans; D008297:Male; D008550:Melatonin / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D018384:Oxidative Stress / Q000187:drug effects; D010919:Placebos; D016896:Treatment Outcome
D000927:Anticonvulsants; D000975:Antioxidants; D010919:Placebos; D002220:Carbamazepine; D005979:Glutathione Peroxidase; D005980:Glutathione Reductase; D008550:Melatonin; C012227:carbamazepine epoxide