Carnitine insufficiency in sodium valproate monotherapy

3rd European Congress of Epileptology -- MAY 24-28, 1998 -- WARSAW, POLANDWOS: 000077228300031It is well known that in patients having NaV therapy, hyperammonemia with carnitine deficiency is frequently observed. In this study, 25 cases (IO male, 15 female; mean age:23) receiving NaV monotherapy for an average of three years; has been given 15 mg/kg carnitine for one month period. At the beginning and at the end of the first month of the therapy the levels of plasma carnitine. ammonium and serum transaminases has been measured. Also patients echocardiogram (ECHO), and electrocardiograms (ECG) were carried out. The results;were compared with the results of 23 normal cases within the same age group. Before the treatment, serum level of NaV was found to be 57.11 mu gr/ml. At the same time carnitine serum level was 5.35 mg/L. NH3's was 41.92 mu mol/ml. At the end of the first month of the therapy; serum level of NaV: 63.67 mu gr/ml, level of carnitine: 9.46 mg/L and NH3 level was found to be 15.95 mu mol/ml, respectively, After treatment a non significant increase in NaV serum level was observed (p:0.207). On the other hand, the increase in plasma level of carnitine (p:0.000), and the reduction in NH3 level (p:0.01) were statistically significant. There were no difference between ECHO and ECG findings before and after treatment which were all within normal limits. The serum level of NaV, the dosage and the period of drug usage did not affect the serum levels of NaV and carnitine. When compared with normal control group, epileptic patients in NaV treatment were determined to have lower serum carnitine levels, and significantly higher serum NH3 levels. Our clinical trial have shown that in epileptic patients treated with NaV; serum carnitine levels decrease, NH, levels increase; and these changes in the body could be repaired by adding carnitine to treatment.Int League Against Epileps