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[Decrease of folic acid and cognitive alterations in patients with epilepsy treated with phenytoin or carbamazepine,
Raul Hernández1, M de los Angeles Fernández, Gabriela Miranda
1Instituto Nacional de Neurología y Neurocirugía Manuel Velazco Suarez.
Summary
Folic acid supplementation improved verbal memory in epileptic patients taking phenytoin or carbamazepine. This safe treatment enhanced cognitive function without altering seizure frequency or antiepileptic drug levels.
Area of Science:
- Neurology
- Clinical Pharmacology
- Nutritional Neuroscience
Background:
- Phenytoin and carbamazepine are globally prevalent antiepileptic drugs.
- These medications can decrease folate levels, potentially impairing cognitive functions.
- Folic acid supplementation may mitigate these cognitive deficits.
Purpose of the Study:
- To evaluate the impact of folic acid on cognitive function in epilepsy patients using phenytoin and/or carbamazepine.
- To assess the safety and efficacy of folic acid in this patient population.
Main Methods:
- A randomized controlled trial involving 18 epilepsy patients on phenytoin/carbamazepine.
- Two groups: one received 5 mg daily folic acid, the other a placebo, for six months.
- Neuropsychological assessments and plasma folate levels were measured at baseline and study end.
Main Results:
- Patients receiving folic acid showed a significant increase in plasma folate levels (p < 0.01).
- Verbal memory skills improved significantly in the folic acid group (p < 0.05).
- No significant changes were observed in seizure frequency or antiepileptic drug plasma levels.
Conclusions:
- Folic acid supplementation is a safe and effective adjunctive treatment for epilepsy patients on phenytoin and carbamazepine.
- Folic acid improves cognitive function, specifically verbal memory, in this patient group.
- The treatment does not interfere with the efficacy of the prescribed antiepileptic drugs.