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The influence of antiepileptic drugs on vitamin B6 metabolism
Insights
Antiepileptic drugs, particularly hydantoin and succinimide, can deplete vitamin B6 levels in children. Supplementing with vitamin B6 is recommended alongside these medications to maintain adequate vitamin B6 nutriture.
Area of Science:
- Biochemistry
- Pediatric Neurology
- Nutritional Science
Background:
- Epileptic children often receive antiepileptic drugs (AEDs).
- Some AEDs may interfere with vitamin metabolism.
- Vitamin B6 (pyridoxine) is crucial for neurological function.
Purpose of the Study:
- To assess vitamin B6 status in epileptic children undergoing AED treatment.
- To investigate the impact of specific AEDs (hydantoin, succinimide) on vitamin B6 metabolism.
- To determine the appropriateness of vitamin B6 supplementation in these patients.
Main Methods:
- Measured erythrocyte glutamate-oxaloacetate transaminase (EGOT) activity in 30 children.
- Assessed serum pyridoxal phosphate (PLP) levels in 27 children.
- Included 25 healthy children as controls.
- Analyzed vitamin B6 nutriture under various AED regimens.
Main Results:
- AED treatment, especially with hydantoin and succinimide, led to decreased EGOT activity.
- Serum PLP levels were also reduced in children on these AEDs.
- The observed changes suggest a disturbance in vitamin B6 metabolism.
Conclusions:
- Antiepileptic drugs, particularly hydantoin and succinimide, may inhibit pyridoxal kinase, affecting vitamin B6 metabolism.
- Vitamin B6 deficiency is a potential concern in epileptic children on these medications.
- Vitamin B6 supplementation is considered appropriate for children treated with hydantoin and succinimide.
Abstract:
Vitamin B6 nutriture was measured by means of determination of activity of EGOT in 30 and of serum pyridoxal phosphate in 27 epileptic children under antiepileptic treatment with various antiepileptic drugs and with hydantoin and succinimide alone, 25 healthy infants and children were controls. Under the treatment with antiepileptic drugs, especially with hydantoin and succinimide a depression of the activity of EGOT and the level of pyridoxal-phosphate in serum followed. As an induction of vitamin B6 dependnet enzyme activity can be excluded a possible explanation for the disturbance in vitamin B6 metabolism could be the inhibition of activity of pyridoxalkinase. We consider the administration of vitamin B6 in addition to hydantoin and succinimide as appropriate.