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| Anticonvulsant
Medications |
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| Valproic Acid Derivatives |
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| Depletions |
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| Carnitine
(L-Carnitine) |
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|
Although carnitine is made by the body, deficiency can occur and may be
associated with anemia, fatigue, increased blood levels of ammonia, lethargy,
unexplained stupor, and heart irregularities. |
|
|
| Copper |
|
|
Although copper deficiency is rare, signs and symptoms of long-term depletion
of copper include anemia, changes in the structure and appearance of hair, heart
damage, growth retardation, impaired bone formation, osteoporosis (bone loss),
and emphysema (lung disease). |
|
|
| Selenium |
|
|
Selenium deficiency may be associated with muscular, digestive, and heart
disorders; long-term deficiency may be associated with increased risk of
developing certain chronic illnesses such as cancer, diabetes, or liver
disease. |
|
|
| Vitamin
B9 (Folic
Acid) |
|
|
Low levels of folic acid have been linked to anemia, heart disease, and birth
defects. |
|
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| Zinc |
|
|
Signs and symptoms of zinc deficiency include loss of appetite or sense of
taste, growth retardation, skin changes, and increased susceptibility to
infection. |
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| Editorial Note |
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| Supporting Research |
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|
Ames BN. Micronutrient deficiencies: A major cause of DNA damage. Ann NY
Acad Sci. 2000;889:87-106.
Castro-Gago, M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine
levels in epileptic children before and during treatment with valproic acid,
carbamazepine, and phenobarbital. J Child Neurol.
1998;13(11):546-549.
Chung S, Choi J, Hyun T, Rha Y, Bae C. Alterations in the carnitine
metabolism in epileptic children treated with valproic acid. JKMS.
1997;12:553-558.
Coulter DL. Carnitine, valproate, toxicity. J Child Neurol.
1991;61(1):7-14.
Covington T, ed. Nonprescription Drug Therapy Guiding Patient
Self-Care. St Louis, MO: Facts and Comparisons; 1999:467-545.
Falchuk KH. Disturbances in Trace Elements. In: Fauci A, Braunwald E,
Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine.
14th ed. New York, NY: McGraw-Hill Companies Health Professional
Division; 1998:490-491.
Goggin T, Gough H, Bissessar A, et al. A comparative study of the relative
effects of anticonvulsant drugs and dietary folate on the red cell folate status
of patients with epilepsy. Q J Med. 1987;65(247):911-919.
Graf WD, Oleinik OE, Glauser TA, et al. Altered antioxidant enzyme activities
in children with a serious adverse experience related to valproic acid therapy.
Neuropediatr. 1998;29(4):195-201.
Hambidge M. Human zinc deficiency. J Nutr. 2000;130(5S
Suppl):1344S-1349S.
Hurd RW, Rinsvelt HA, Wilder RJ, et al. Selenium, zinc, and copper changes
with valproic acid: possible relation to drug side effects. Neurol.
1984;34(10):1393-1395.
Kaji M, Ito M, Okuno T, et al. Serum copper and zinc levels in epileptic
children with valproate treatment. Epilepsia. 1992;33(3):555-557.
Lerman-Sagie T, Statter M, Szabo G, et al. Effect of valproic acid therapy on
zinc metabolism in children with primary epilepsy. Clin Neuropharmacol.
1987;10(1):80-86.
National Research Council. Recommended Dietary Allowances.
10th ed. Washington, DC: National Academy Press; 1989.
Navarro-Alarcon M, Lopez-Martinez MC. Essentiality of selenium in the human
body: relationship with different diseases. Sci Total Environ.
2000;249:347-371.
Sozuer DT, Baruteu UB, Karakoe Y, et al. The effects of antiepileptic drugs
on serum zinc and copper levels in children. J Basic Clin Physiol
Pharmacol. 1995;6(3-4):265-269.
Van Wouwe JP. Carnitine deficiency during valproic acid treatment. Int J
Vitam Nutr Res. 1995;65(3):211-214. |
|
| Review Date:
October 2000 |
Reviewed By:
All depletions monographs have been reviewed by a
team of experts including
Derrick M. DeSilva, Jr., MD, Raritan Bay Medical Center, Perth Amboy, NJ;
Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley
Hospital, Harvard University and Senior Medical Editor, A.D.A.M., Inc., Boston,
MA; John Hinze, PharmD, NMD, Woodbine, IA; Ruth Marlin, MD, Medical Director and
Director of Medical Education, Preventive Medicine Research Institute,
Sausalito, CA; Brian T Sanderoff, PD, BS in Pharmacy, Clinical Assistant
Professor, University of Maryland School of Pharmacy; President, Your
Prescription for Health, Owings Mills, MD; Leonard Wisneski, MD, FACP, George
Washington University, Rockville, MD; Ira Zunin, MD, MPH, MBA, President and
Chairman, Hawaii State Consortium for Integrative Medicine, Honolulu,
HI.
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The publisher does not accept any responsibility for the
accuracy of the information or the consequences arising from the application,
use, or misuse of any of the information contained herein, including any injury
and/or damage to any person or property as a matter of product liability,
negligence, or otherwise. No warranty, expressed or implied, is made in regard
to the contents of this material. No claims or endorsements are made for any
drugs or compounds currently marketed or in investigative use. This material is
not intended as a guide to self-medication. The reader is advised to discuss the
information provided here with a doctor, pharmacist, nurse, or other authorized
healthcare practitioner and to check product information (including package
inserts) regarding dosage, precautions, warnings, interactions, and
contraindications before administering any drug, herb, or supplement discussed
herein. |
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