Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children.

@article{Hug1991ReductionOS,
  title={Reduction of serum carnitine concentrations during anticonvulsant therapy with phenobarbital, valproic acid, phenytoin, and carbamazepine in children.},
  author={George Hug and Catherine A. McGraw and Sandra R. Bates and E Landrigan},
  journal={The Journal of pediatrics},
  year={1991},
  volume={119 5},
  pages={
          799-802
        }
}

Serum Carnitine Levels in Epileptic Children Before and During Treatment With Valproic Acid, Carbamazepine, and Phenobarbital

Serum levels of free, acyl, and total carnitine were determined in 32 patients with seizures, before and after 3, 6, and 12 months of treatment with valproic acid, carbamazepine, or phenobarbital, and these findings suggest a need to monitor serum carnite levels in children treated with any of these drugs.

Serum Carnitine Levels During Oxcarbazepine and Carbamazepine Monotherapies in Children With Epilepsy

The results suggest that neither oxcarbazepine nor carbamazepine as monotherapy causes carnitine deficiency in otherwise healthy children with primary idiopathic epilepsy.

[The decreased level of plasma carnitine in patients with epilepsy].

  • E. Belousova
  • Medicine, Psychology
    Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova
  • 2017
It was established that body weight, height and multidrug therapy are significantly associated with low level of free plasma in epileptic patients and some findings indicate that the number of AEDs used is a risk factor for carnitine deficiency.

Vigabatrin, lamotrigine, topiramate and serum carnitine levels.

ANTIEPILEPTIC DRUG THERAPY AND SERUM CARNITINE LEVELS IN CHILDREN PRIOR TO AND FOLLOWING TREATMENT

It is recommended that a carnitine supplement be administered in pediatric epileptic patients to prevent the deficiency and related consequences caused by such therapies caused by antiepileptic drugs.

Impaired fatty acid oxidation in children on valproic acid and the effect of L‐carnitine

It is suggested that, in patients at low risk for VPA-induced hepatotoxicity (patients aged >2 years and taking VPA as monotherapy), VPA causes metabolic abnormalities resembling those found in inborn errors of mitochondria1 β-oxidation which are not corrected by L-carnitine.

Plasma carnitine levels in children with idiopathic epilepsy treated with old and new antiepileptic drugs

Carnitine deficiency is not uncommon among children with epilepsy and is mainly linked to valproate therapy, and in contrast, new-generation AEDs probably do not cause carnitine deficiencies.

The correlation between carbamazepine and valproic acid monotherapy with serum adiponectin and carnitine

There was a negative but insignificant correlation between the duration and dose of carbamazepine and valproic acid drug use and serum adiponectin and carnitine levels.

Analysis of acylcarnitine levels by tandem mass spectrometry in epileptic children receiving valproate and oxcarbazepine

It is indicated that there are significant biochemical changes in acylcarnitines in ambulatory children on VPA monotherapy but these are not clinically significant.
...

References

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Serum Carnitine During Valproic Acid Therapy

The reduction of carnitine in the serum of VPA‐treated patients is most probably due to alterations of fatty acid metabolism, which can be the only reason for the VPA-induced fatal hepatotoxicity.

Valproate, Carnitine Metabolism, and Biochemical Indicators of Liver Function

The data support the assumption that carnitine deficiency and abnormal liver function due to VPA are mostly subclinical events.

Carnitine deficiency associated with anticonvulsant therapy.

Hypocarnitinemia in the handicapped individuals who receive a polypharmacy of antiepileptic drugs.

Results indicate that although sodium valproate itself reduces the carnitine concentrations in serum, a poor muscle volume and co-administration of phenytoin with sodium Valproate enhance hypocarnitinemia.

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An improved and simplified radioisotopic assay for the determination of free and esterified carnitine.

The radioisotopic assay for carnitine first described by Cederblad and Lindstedt and modified by Bohmer et al has been improved and simplified and yields a linear response over a wide range of carnItine concentrations without the need for excessive amounts of labeled acetyl-CoA.

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The scientific basis of myology general approaches to neuromuscular diseases diseases of muscle and how these approaches are applied to clinical practice are described.