Serum Homocysteine, Folate, and Vitamin B12 Levels in Carbamazepine Treated Epileptic Children

Antiepileptic drugs (AEDs) have been associated with metabolic consequences that lead to an increase in risk of atherosclerosis in patients with epilepsy. Therefore, we evaluated whether differences exist in homocysteine, folate, and vitamin B12 levels in children receiving carbamazepine (CBZ) monotherapy.

A total of 58 newly diagnosed epileptic children with ages ranging from 2 to 15 years were enrolled at the start of study. However, after 3 months follow up, the final total sample size was only 50 epileptic children. Eight children dropped out of the study due to poor follow up. Serum homocysteine levels were measured by enzyme immunoassay method. Serum folate and vitamin B12 levels were estimated by Competitive Chemiluminescent Enzyme Immunoassay method.

The serum homocysteine level in epileptic children was found to be significantly increased after carbamazepine (CBZ) monotherapy as compared to before therapy. Moreover, a highly significant decrease was observed in the serum folate and vitamin B12 levels, after carbamazepine monotherapy as compared to before therapy in epileptic children.

Carbamazepine monotherapy may cause a significant increase in the levels of homocysteine and a significant decrease in the levels of serum folate and vitamin B12 in children with epilepsy, significant changes in above mentioned parameters occurring early in the course of treatment. The atherogenic effect of increased serum homocysteine level is well established, and patients under carbamazepine monotherapy should be monitored for possible atherogenic effects. Therefore, it may be useful to measure serum homocysteine, folate, and vitamin B12 concentrations routinely in children with epilepsy taking carbamazepine monotherapy and be treated when their levels are found to be disturbed.