Goggin T, Gough H, Bissessar A, Crowley M, Baker M, Callaghan N
Department of Neurology, Cork Regional Hospital, Ireland.
Q J Med. 1987 Nov;65(247):911-9.
In a survey of the red cell folate status of 200 patients with epilepsy, compared to 72 controls, we found that median red cell folate levels were reduced significantly in patients treated with phenytoin (p less than 0.01) or carbamazepine (p less than 0.001) alone. Patients taking more than one drug had reduced levels also (p less than 0.001), but in patients treated with sodium valproate alone there was no significant decrease in red cell folate levels compared to controls. Twenty-two per cent of patients in the group taking more than one drug had reduced levels of red cell folate compared with 17 per cent of those taking carbamazepine alone, 13 per cent of those taking phenytoin only, and 9 per cent of those taking sodium valproate only. Dietary folate intake was significantly reduced in all the patient groups compared with controls (p less than 0.001 for the carbamazepine and phenytoin groups, p less than 0.01 for the polypharmacy and sodium valproate groups); a significant correlation between red cell folate levels and dietary folate was not established. Significant negative relationships were established between carbamazepine dose (r = -0.35, p less than 0.01) or serum level (r = -0.27, p less than 0.05) and red cell folate level in patients on one drug only. The correlation between dose or serum level of phenytoin and red cell folate level was also negative but did not reach significance. Our findings show that all anticonvulsant drugs interfere with folate metabolism.(ABSTRACT TRUNCATED AT 250 WORDS)
在一项对200例癫痫患者红细胞叶酸水平的调查中，与72名对照者相比，我们发现单独使用苯妥英（p<0.01）或卡马西平（p<0.001）治疗的患者，其红细胞叶酸水平中位数显著降低。服用多种药物的患者叶酸水平也降低（p<0.001），但单独使用丙戊酸钠治疗的患者与对照者相比，红细胞叶酸水平没有显著下降。服用多种药物组中22%的患者红细胞叶酸水平降低，而单独服用卡马西平组为17%，仅服用苯妥英组为13%，仅服用丙戊酸钠组为9%。与对照者相比，所有患者组的膳食叶酸摄入量均显著降低（卡马西平和苯妥英组p<0.001，联合用药组和丙戊酸钠组p<0.01）；红细胞叶酸水平与膳食叶酸之间未建立显著相关性。仅服用一种药物的患者中，卡马西平剂量（r = -0.35，p<0.01）或血清水平（r = -0.27，p<0.05）与红细胞叶酸水平之间建立了显著负相关。苯妥英剂量或血清水平与红细胞叶酸水平之间的相关性也为负，但未达到显著水平。我们的研究结果表明，所有抗惊厥药物都会干扰叶酸代谢。（摘要截短至250字）
