Possible Interaction: Carbamazepine and Homocysteine

“After 1 year of therapy, patients treated with VPA and CBZ showed a significant increase of the plasma concentrations of Hcy when compared to baseline data and controls values.”

“Psychiatrists may find it advisable to control the levels of folate and homocysteine in adults and children who are taking carbamazepine and to measure homocysteine level in children taking valproic acid.”

“The atherogenic effect of increased serum homocysteine level is well established, and patients under carbamazepine monotherapy should be monitored for possible atherogenic effects.”

“We found that mean serum folate level was statistically lower and mean Hcy level was higher in epileptic patients receiving CBZ or VPA when compared with those of controls'.”

“Additionally, the underlying mechanism for homocysteine increase seems to be a decrease of cofactor molecules in patients using carbamazepine and phenytoin (pyridoxal 5'-phosphate and folic acid, respectively).”

“In the carbamazepine-treated group , significantly positive correlation was found between duration of treatment and homocysteine concentration (p < 0.01).”

“After treatment with carbamazepine combined with vitamin B12 for patients with epilepsy, the Hcy level was significantly higher than that before treatment and that in the control group (P<0.01).”

“Conclusions According to the … this study, as carbamazepine and valproate sodium consumption can … elevated serum levels of homocysteine and decreased levels of folate and vitamin B12, and the atherogenic effect of increased serum homocysteine … is well established, the patients under these medications should be monitored for possible atherogenic effects.”