title: Modified Atkins diet may reduce serum concentrations of antiepileptic drugs.
abstract: BACKGROUND
  Modified Atkins diet is a treatment option for patients with pharmacoresistant epilepsy that is not suitable for surgery. In the last few years, we have tried dietary treatment added to antiepileptic drugs (AEDs) in adult patients with severe epilepsy.
  
  
  OBJECTIVE
  To examine a possible pharmacokinetic interaction between the modified Atkins diet and AEDs.
  
  
  METHODS
  In four patients, AED serum concentrations were measured before onset and after 4 and 12 weeks on the diet. The patients used combinations of two or three AEDs, including carbamazepine, clobazam, lamotrigine, nitrazepam, oxcarbazepine, valproate, zonisamide, and topiramate. The patients did not change the type or dose of their AEDs during the diet period.
  
  
  RESULTS
  After 12 weeks on the diet, the average serum concentrations of the respective AEDs were reduced by 35% (range 6-46%) compared to prediet values.
  
  
  CONCLUSIONS
  Modified Atkins diet used as add-on therapy to AEDs in four patients with drug resistant seizures caused a considerable decrease in AED serum concentrations. In individual patients, this could be of clinical relevance, and we recommend that AED serum concentrations should be closely monitored when offering this diet to adults with epilepsy.
authors.affiliation: Department of Refractory Epilepsy-SSE, Oslo University Hospital, Sandvika, Norway.
authors.forename: M
authors.initials: M
authors.lastname: Kverneland
authors.affiliation: Department of Neurology, Oslo University Hospital and University of Oslo, Oslo, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Taubøll
authors.affiliation: Department of Medical Genetics, Oslo University Hospital and University of Oslo, Oslo, Norway.
authors.forename: K K
authors.initials: KK
authors.lastname: Selmer
authors.affiliation: Department of Nutrition, University of Oslo, Oslo, Norway.|Haematology, Oslo University Hospital, Oslo, Norway.
authors.forename: P O
authors.initials: PO
authors.lastname: Iversen
authors.affiliation: Department of Refractory Epilepsy-SSE, Oslo University Hospital, Sandvika, Norway.
authors.forename: K O
authors.initials: KO
authors.lastname: Nakken
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000097:blood* / Q000627:therapeutic use*; D050528:Diet, Carbohydrate-Restricted / Q000009:adverse effects*; D004827:Epilepsy / Q000178:diet therapy* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000927:Anticonvulsants
keywords: antiepileptic drugs; ketogenic diet; modified Atkins diet; refractory epilepsy