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Supplements
Vitamins
Anticonvulsant medication may affect the levels of vitamins B2, B6, B22, C, D, E, beta-carotene, biotin and folate. It has been suggested that some of these deficiencies may be involved in the development of certain behavioural disturbances. These deficiencies may also worsen some of the toxic effects of AEDs. A deficiency of vitamin B6 (pyridoxine), which may be diagnosed at birth, can cause a seizure disorder. The need for replacement therapy remains controversial, since some vitamins may reduce the efficacy of antiepileptic drugs or may even cause seizures (folic acid replacement). Although there is the risk of increased seizures while taking folic acid supplements, women who are trying to conceive, and those who are pregnant, are encouraged to take folic acid replacements. A deficiency in folic acid may lead to an increased chance of experiencing a miscarriage (spontaneous abortion) or having a child with birth defects. It is recommended that you talk to your doctor when considering pregnancy.
Vitamin B23 (carnitine) is a protein found in all tissues and is essential for life. Plasma levels are usually low in people with epilepsy, who are taking a combination of valporate with other anti-epileptic drugs (AEDs), such as phenobarbital, phenytoin or carbamazepine. Carnitine is sometimes used in conjunction with AEDs or the ketogenic diet. It is found in high quantities in red meat and milk products. It is available in a pharmaceutical form (Carnitor). Adverse effects of taking carnitine supplements may included transient nausea, vomiting, abdominal cramps, and diarrhea. Less frequently, foul body odour or gastrointestinal symptoms may occur.
Minerals and Hormones
Decreased levels of calcium and magnesium can predispose a person with epilepsy to experiencing seizures. However, there is not evidence that additional calcium or magnesium in the diet have any beneficial effect in the general management of epilepsy. Some have suggested that elevated zinc levels may play a role in the exacerbation of epileptic seizures, although further investigation is required.
Melatonin (a hormone) is a natural substance produced in the brain by the pineal gland. It is primarily used for jet lag, but recent animal studies have found that it may show anticonvulsant effects. Further investigation is still required to determine its efficacy in humans and its long-term efficacy. While it can be purchased from health food stores in the USA and elsewhere, it is not available in Canada.
Amino Acids
The amino acids taurine and tryptophan have been used as adjunctive treatments for various types of epilepsy. Taurine is a conditionally essential amino acid, which is not used in protein synthesis, but rather is found free or in simple peptides. Clinically, taurine has been used with varying degrees of success in the treatment of a wide variety of conditions, including: cardiovascular diseases, hypercholesterolemia (excess of cholesterol in the blood), epilepsy and other seizure disorders. Tryptophan is also an essential amino acid. It is a natural relaxant, helps alleviate insomnia by inducing normal sleep, reduces anxiety and depression, helps in the treatment of migraine headaches, helps the immune system, helps reduce the risk of heart and artery spasms, and helps in reducing cholesterol levels. However, their effects have not been well studied; further investigation to determine their efficacy is necessary.
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