Carnitine disposition before and during valproate therapy in patients with epilepsy

R. Riva, F. Albani, G. Gobbi, M. Santucci, A. Baruzzi, P. Genton, A. Portera- Sanchez, C. K. Benninger

Research output: Contribution to journalArticle

Abstract

Free and total carnitine and acylcarnitine in plasma and urine samples was measured in 22 epileptic patients before and after 15 and 45 days of valproate (VPA) therapy and in 16 healthy volunteers on a single occasion. Carnitine plasma concentration and renal excretion observed in epileptic patients before VPA therapy did not differ from control values. After VPA was started, free and total plasma concentration decreased significantly (p <0.05) from 49 ± 17 to 35 ± 16 at 15 days and to 35 ± 13 nmol/ml at 45 days of therapy (free carnitine) and from 60 ± 18 to 50 ± 18 at 15 days and to 55 ± 14 nmol/ml at 45 days of therapy (total carnitine), whereas acylcarnitine increased significantly (p <0.05) from 10 ± 8 to 14 ± 8 at 15 days and to 18 ± 16 nmol/ml at 45 days of therapy. Free carnitine urinary excretion decreased significantly (p <0.05) from 200 ± 135 to 115 ± 76 and 118 ± 75 μmol/24 h, whereas acylcarnitine urinary excretion increased significantly (p <0.05) from 78 ± 56 to 154 ± 98 and 155 ± 89 μmol/24 h after VPA therapy was started. As a consequence, acylcarnitine renal clearance increased significantly (+30%, p <0.05) whereas free carnitine renal clearance did not change during VPA therapy. No difference was detected between 15 and 45 days of therapy. No patients experienced symptoms of VPA toxicity. Our results suggest that VPA in patients increases both formation and renal clearance of acylcarnitine.

Original languageEnglish
Pages (from-to)184-187
Number of pages4
JournalEpilepsia
Volume34
Issue number1
DOIs
Publication statusPublished - 1993

Keywords

  • Anticonvulsants
  • Carnitine
  • Drug toxicity
  • Valproate

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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    Riva, R., Albani, F., Gobbi, G., Santucci, M., Baruzzi, A., Genton, P., Portera- Sanchez, A., & Benninger, C. K. (1993). Carnitine disposition before and during valproate therapy in patients with epilepsy. Epilepsia, 34(1), 184-187. https://doi.org/10.1111/j.1528-1157.1993.tb02396.x