title: The effect of vitamin B supplementation on homocysteine metabolism and clinical state of patients with chronic epilepsy treated with carbamazepine and valproic acid.
abstract: OBJECTIVE
  To investigate the influence of vitamin B supplementation on the plasma total homocysteine (p-tHcy), serum folate (s-FA), serum B12 (s-B12), and clinical state of patients with chronic epilepsy.
  
  
  METHODS
  Beck Depression Inventory (BDI) scores and p-tHcy, s-B12, and s-FA levels were assessed at baseline, after 1 year of supplementation (G1), and before and after 1 year of VPA or CBZ therapy (G2).
  
  
  RESULTS
  Eighty-one patients participated in the study: 51 patients with chronic epilepsy (G1) treated with carbamazepine (CBZ) or valproic acid (VPA), and 30 patients with newly diagnosed epilepsy (G2). At baseline, mean p-tHcy level was significantly higher in G1 than G2 (p=0.0001) with no significant differences in s-FA or s-B12 levels. p-tHcy level significantly decreased in CBZ-treated G1 patients (p=0.00002) after 1 year of supplementation and increased in G2 after 1 year of anti-epileptic drug (AED) therapy without supplementation. BDI scores in G1 decreased significantly after 1 year of supplementation (p=0.0001) and increased significantly in VPA-treated G2 patients after 1 year of AED therapy (p=0.02). The number of hyperhomocysteinemic patients significantly decreased in G1 after vitamin B supplementation (p=0.01) and increased in G2 (p=0.002). We also observed improved BDI scores and reduced seizure frequency in patients with chronic epilepsy.
  
  
  CONCLUSIONS
  These data support the hypothesis that AEDs play a major role in hyperhomocysteinemia development in patients with epilepsy. Adding folate and vitamin B12 to AED therapy is a safe and inexpensive way to reduce the risk of hyperhomocysteinemia.
authors.affiliation: I(st) Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland. abochyn@ipin.edu.pl
authors.forename: Anna
authors.initials: A
authors.lastname: Bochyńska
authors.forename: Wanda
authors.initials: W
authors.lastname: Lipczyńska-Łojkowska
authors.forename: Magdalena
authors.initials: M
authors.lastname: Gugała-Iwaniuk
authors.forename: Waldemar
authors.initials: W
authors.lastname: Lechowicz
authors.forename: Magdalena
authors.initials: M
authors.lastname: Restel
authors.forename: Ałła
authors.initials: A
authors.lastname: Graban
authors.forename: Beata
authors.initials: B
authors.lastname: Lipska
authors.forename: Danuta
authors.initials: D
authors.lastname: Ryglewicz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage*; D002220:Carbamazepine / Q000008:administration & dosage; D019587:Dietary Supplements; D004827:Epilepsy / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D014635:Valproic Acid / Q000008:administration & dosage; D014805:Vitamin B 12 / Q000008:administration & dosage*; D014803:Vitamin B Complex / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D006710:Homocysteine; D014803:Vitamin B Complex; D002220:Carbamazepine; D014635:Valproic Acid; D005492:Folic Acid; D014805:Vitamin B 12