Article: Fasting and post-methionine loading concentrations of homocysteine, vitamin B^sub 2^, and vitamin B^sub 6^ in patients on antiepileptic drugs

Patients on antiepileptic drugs (AEDs) frequently have low serum folate and high plasma total homocysteine (tHcy) (1-4). This metabolic disturbance has been implicated in an increased rate of cardiovascular disease, fetal mal formations, dementia, and neuropsychiatric symptoms among patients on AEDs (5-7). Homocysteine metabolism is dependent on four B vitamins as cofactors: The methylation of homocysteine to methionine requires folate and vitamin B12, and the irreversible transsulfuration to cysteinc requires vitamin B6 (8). The recycling of folate cofactors is dependent on vitamin B6 and B2, and vitamin B2 is necessary for activating vitamin B6 to pyridoxal 5'-phosphate (PLP) (9). Vitamin ...

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