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Anticonvulsant medications - valproic acid derivatives

Medications:
  • Valproic Acid and Derivatives
    • Depacon
    • Depakene
    • Depakote Delayed Release
    • Depakote ER


Depletions:

Calcium

Osteoporosis (bone loss) is the main disease that comes from not getting enough calcium. Lack of calcium also may be linked with bone pain and spinal problems. Low levels can also cause muscle cramps, irregular heartbeat, and depression.

Carnitine (L-Carnitine)

Usually healthy people get enough carnitine because the body makes all it needs. But sometimes you can have low levels of carnitine. Being deficient in carnitine can cause muscle aches, fatigue, confusion, and heart problems.

Copper

It's rare to have low levels of copper. Signs and symptoms of low levels of copper over a long period of time include anemia, changes in the structure and appearance of hair, heart damage, slow growth, problems with bone formation, osteoporosis (bone loss), and emphysema (lung disease).

Vitamin B3 (Niacin)

Niacin plays a key role in the body's metabolism, and low levels can lead to problems with the skin, digestive system, and nervous system. Symptoms include fatigue, stomach problems, depression, and vomiting. Severe deficiency can cause pellagra, a disease that can be life-threatening if not treated. Symptoms of pellagra include inflammation of the skin, depression, abdominal pain, and diarrhea.

Selenium

Not getting enough selenium over a period of time may make you more susceptible to developing other conditions, such as cancer, diabetes, or liver disease. Low levels of selenium may be linked to problems with the muscles, heart, and digestive system.

Vitamin B9 (Folic Acid)

Low levels of folic acid have been linked to anemia, heart disease, birth defects, and colon cancer. Symptoms may include fatigue, mouth sores, swollen tongue, and poor growth.

Zinc

Signs and symptoms of low levels of zinc include loss of appetite or sense of taste, weakened immune system, slow growth, skin changes, and being more susceptible to infection.



Editorial Note:

The information presented here covers some of the nutrients that may be lowered when you take certain medications. The signs and symptoms listed can be caused by other conditions. So if you have these signs and symptoms, it doesn't always mean you have low levels of these nutrients. Many things affect the level of nutrients, including your medical history, diet, and lifestyle, as well as how long you have been taking the medication. Please talk with your health care provider. He or she can best address your health care needs and see if you are at risk for low levels of any nutrients.



Supporting Research:

Alexander J. Selenium. Novartis Found Symp. 2007;282:143-9; discussion 149-53, 212-8.

Ames BN. Micronutrient deficiencies: A major cause of DNA damage. Ann NY Acad Sci. 2000;889:87-106.

Araya M, Pizarro F, Olivares M, Arredondo M, González M, Méndez M. Understanding copper homeostasis in humans and copper effects on health. Biol Res. 2006;39(1):183-7.

Felipez L, Sentongo T. Drug-Induced Nutrient Deficiencies. Pediatric Clinics of North America. 2009; 56(5).

Hoffmann PR. Mechanisms by which selenium influences immune responses. Arch Immunol TherExp (Warsz). 2007; [Epub ahead of print].

Lyon VB, Fairley JA. Anticonvulsant-induced pellagra. J Am Acad Dermatol. 2002;46:597-9.

Maret W, Sandstead HH. Zinc requirements and the risks and benefits of zinc supplementation. J Trace Elem Med Biol. 2006;20(1):3-18.

Navarro-Alarcon M, Lopez-Martinez MC. Essentiality of selenium in the human body: relationship with different diseases. Sci Total Environ. 2000;249:347-371.

Pelton R, LaValle J, Hawkins EB, et al. Drug Induced Nutrient Depletion Handbook. Hudson, OH:LexiComp, Inc. 2001:405-408.

Powell SR. The antioxidant properties of zinc. J Nutr. 2000;130(5S Suppl):1447S-54S.

Russell S. Carnitine as an antidote for acute valproate toxicity in children. Curr Opin Pediatr. 2007;19(2):206-10.

Tsai MF, Chen CY. Valproate-induced hyperammonemic encephalopathy treated by hemodialysis. Ren Fail. 2008; 30(8):822-4.

Tubek S, Grzanka P, Tubek I. Role of Zinc in Hemostasis: A Review. Biol Trace Elem Res. 2007; [Epub ahead of print].

Yilmaz Y, Tasdemir HA, Paksu MS. The influence of valproic acid treatment on hair and serum zin levels and serum biotinidase activity. Eur J Paediatr Neurol. 2009;13(5):439-43.




Review Date: 9/29/2012
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed HealthCare Network.

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