Objective. To present the current state of knowledge on the effects of anti-epileptic drugs on the metabolism of homocysteine in patients with epilepsy, and discuss its clinical consequences.
Review: Homocysteine (Hcy), an amino acid produced in the exogenous pathway of metionine, is essential for the proper development of the nervous system. Hyperhomocysteinemia (hHcy) is a riskfactorfor cerebrovascular disease, dementia, inborn defects and impaired cognitive functions. Some antiepileptic drugs can change metabolism of homocysteine, leading to an alteration of the plasma Hcy levels. Vitamin B and folate supplementation is a strategy to reduce Hcy levels in patients with epilepsy, treated with antiepileptic drugs.
Conclusions. Better knowledge of the pathomechanisms of various clinical conditions should help neurologists prevent many dangerous complications more effectively. It should also improve patients' quality of life, their compliance and adherence.