Possible Interaction: Anticonvulsants and Folic Acid

“It is assumed that anticonvulsants interfere with conversion of folic acid to 5-methyltetrahydrofolate, a form which enters the CSF.”

“A conditioned marginal or frank deficiency of folic acid can result from oral contraceptives and administration of anticonvulsants ; if studies are done in animals using these types of chemicals, dietary folate will be highly significant.”

“ Folic acid and its derivatives have significant convulsant properties and can reverse the anticonvulsant effect of the drugs experimentally, and sometimes clinically, especially when the blood/brain barrier to the vitamin is damaged or circumvented.”

“ Anticonvulsant interaction with folic acid and phytomenadione (vitamin K) metabolism may lead to an increased risk for neural tube defect and early neonatal bleeding.”

“Supplementation with folic acid , vitamin B6, biotin, vitamin D, and L-carnitine may be needed to prevent or treat deficiencies resulting from the use of anticonvulsant drugs.”

“This may be avoided by prophylactic administration of folic acid to patients with seizure who will be on long-term anticonvulsant treatment.”

“It would therefore seem that the depression of folic acid levels in patients on anticonvulsants depends on individual factors and perhaps duration of treatment rather than being a toxic, dose-dependent response.”

“Although it is not the current standard of practice, adding a multiple vitamin containing folic acid to the regimen of men and women starting anticonvulsant medication should be considered in order to prevent the folate lowering observed with such commonly used drugs as PHT and carbamazepine.”

“Higher dosages of folic acid may make vitamin B12 deficiency difficult to diagnose and may alter seizure frequency in patients with epilepsy due to drug interactions with anticonvulsants.”

“A population of mentally retarded and physically disabled individuals on long-term therapy with anticonvulsant drugs had a high prevalence of folic acid and riboflavin deficiency, 20% and 17%, respectively, as they entered an institution devoted to their care.”