항경련제가 혈청 Carnitine 및 간 기능에 미치는 영향

The Effects of Antiepileptic Drugs on Serum Carnitine and Liver Function

We measured the serum carnitine levels by means of radioisotopic assay in epileptic children receiving a various antiepileptic drugs, and assessed the effects of antiepileptic drugs on serum carnitine level together with a correlation between serum carnitine level and duration of treatment, and value of liver function. The study included 97 epileptic patients(54 males, 43 females ; ages 5-23 years) who were divided into four antiepileptic drug-treated groups : valproic acid(VPA) monotherapy, carbamazepine monotherapy, valproic acid polytherapy, and other antiepileptic drugs without VPA, and a control group of 52 children(33 males, 19 females ; ages 8-19 years). The results were as follows: 1. The serum levels of total and free carnitine were significantly reduced in the patients of VPA mono- and polytherapy groups, compared with the control group. The reduction was more significant in the patients of VPA polytherapy group than in those of VPA monotherapy group. 2. The number of patients whose serum level of total and free carnitine reduced by > 2SD below the mean of control group was 3 of 18 patients in VPA monotherapy group and 6 of 20 patients in VPA polytherapy group, respectively. 3. The duration of treatment was not correlated with the serum levels carnitine in both VPA mono- and polytherapy groups. 4. The blood level of ammonia was inversely correlated with the serum level of carnitine in both VPA mono- and polytherapy groups. It can be concluded that reduction of serum carnitine should be considered in epileptic patients taking VPA therapy, although the clinical symptoms of carnitine deficiency were not found in patients of our study, and the measurement of blood ammonia may be the useful parameter to predict hypocarnitinemia.