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. 2019 Jul;26(3-4):50-54.
doi: 10.1177/0972753120925560. Epub 2020 May 17.

Efficacy Study of Folic Acid Supplementation on Homocysteine Levels in Adolescent Epileptics Taking Antiepileptic Drugs: A Single Blind Randomized Controlled Clinical Trial

Uma A Bhosale  1 , Radha Yegnanarayan  1 , Akhil Agrawal  1 , Ashwini Patil  1
Affiliations

Efficacy Study of Folic Acid Supplementation on Homocysteine Levels in Adolescent Epileptics Taking Antiepileptic Drugs: A Single Blind Randomized Controlled Clinical Trial

Uma A Bhosale et al. Ann Neurosci. 2019 Jul.

Abstract

Background: Epilepsy is a chronic medical condition that requires long-term therapy with antiepileptic drugs (AEDs). However, long-term employment of AEDs may lead to the onset of hyperhomocysteinemia, which has been found to modulate imperative metabolic mechanisms and induce cardiovascular disorders (CVDs). Therefore, adolescent population that have been diagnosed with epilepsy and utilize AEDs are among the most vulnerable, exhibiting higher risks of developing CVDs.

Purpose: The present study was designed to explore the effects of folic acid (FA) supplementation on AED-induced hyperhomocysteinemia and CVD risk factors in adolescent epileptics.

Methods: The randomized clinical trial included adolescent epileptics (i.e., 10-19 years of age) of either sex, on antiepileptic therapy for > 6 months with high homocysteine levels (i.e., >10.9 µmol/L). At the time of enrolment, their baseline BP, lipid and homocysteine levels were recorded. Participants were randomly assigned to either treatment or placebo groups and received the respective treatments. At the end of the first month, BP, lipid and homocysteine levels were recorded and compared to determine the effect of FA on these parameters.

Results and conclusion: A significant fall in homocysteine levels was observed with FA supplementation (P < 0.05). However, this fall was significantly high in valproic acid treated epileptic patients. In addition, we observed an improvement in high-density lipoprotein levels, a risk factor for CVDs, but the change was statistically insignificant (P > 0.05). The study results suggest that FA supplementation in epileptic patients receiving AED therapy may minimize AED-induced hyperhomocysteinemia and other CVD risk factors.

Keywords: AEDs; Adolescent; CVD; folic acid; hyperhomocysteinemia.

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Figures

Figure 1.
Figure 1.. Homocysteine Metabolism Pathway
Figure 2.
Figure 2.. Homocysteine Levels in Epileptics Receiving Various AEDs
Figure 3.
Figure 3.. Effect of Folic Acid Supplementation and Placebo on Homocysteine Levels in Various AEDs
Figure 4.
Figure 4.. Folate Synthetic Pathway
None
See this image and copyright information in PMC

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