Aucte intermittent porphyria and epilepsy.

Biagini, R; Tignani, R; Fifi, A R; Nappini, L

doi:10.1136/adc.54.8.644

Cited by 13 publications

(4 citation statements)

References 5 publications

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“…In patients affected by acute intermittent porphyria, where severe attacks are known to be precipitated by enzyme-inducing antiepileptic drugs such as barbiturates and hydantoins, valproate or clonazepam may be safe (Larson et al, 1978;Biagini et al, 1979).…”

Section: Gastrointestinal Disordersmentioning

confidence: 99%

Adverse Effects of Valproate

Schmidt

1984

Epilepsia

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Any review on adverse effects alone without due reference to the therapeutic benefits of a valuable drug is in danger of exaggerating the side effects. Nevertheless, it is reasonable to expect that some of the signs and symptoms seen in patients with epilepsy may not be due to the epilepsy but rather to the adverse effects of antiepileptic drugs (Schmidt and Seldon, 1982). Awareness of the common and the less well‐known adverse effects will increase the safety of a drug, such as valproate, that is taken chronically by many patients worldwide. From a clinical perspective, any unwanted reaction may be seen as an adverse effect. Adverse effects can usually be classified in a small number of rather rare but sometimes fatal and mostly unpredictable drug‐induced diseases or in more frequent, mostly mild, dose‐related, and reversible side effects (Schmidt, 1983). The adverse effects of valproate are difficult to classify in that scheme, because dose dependency is rare and the mechanisms of most adverse reactions are not well understood. It may therefore be useful to start with an overview of the common adverse effects observed in therapeutic trials, followed by a review of the individual organ systems involved in the adverse effects of valproate, including rather rare drug‐induced diseases. The purpose of this review is to provide an overview of the adverse effects of valproate, except for its hepatotoxic and teratogenic actions, which will be covered by Prof. Jeavons (S50–55).

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Section: Gastrointestinal Disordersmentioning

confidence: 99%

Adverse Effects of Valproate

Schmidt

1984

Epilepsia

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“…Some reports demonstrate the safety of valproate in porphyria. 26,27 Valproate was given to our patient twice but withdrawn each time because of her bad clinical signs. Phenytoin was also discontinued because it exacerbated the seizure disorder.…”

Section: Discussionmentioning

confidence: 99%

Microsomal Enzyme Induction and Clinical Aggravation of Porphyria: The Evaluation of Human Urinary 6β‐Hydroxycortisol/Cortisol Ratio as the Index of Hepatic CYP3A4 Activity

Uejima

Takahashi

Morisaki

et al. 2002

The Journal of Clinical Pharma

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The clinical aspect of porphyria has been investigated, and it is well known that porphyrinogens such as estrogens and alcohol or other inducers of P450 isoenzymes exacerbate the porphyric state. However, there can be a delay in diagnosing porphyria and a difficulty in selecting safe medicine for it even today. A 21-year-old woman developed epilepsy, disturbance of mental state, and spastic tetraparesis during the convalescent period after acute viral encephalitis. She was diagnosed with porphyria after the fifth hospitalization. In the course of modifying her anticonvulsant regimen, the authors examined the 6beta-hydroxycortisol/cortisol ratio (6beta-OHF/F) in her urine, which can be the index of hepatic CYP3A4 activity, with electrospray ionization/mass spectrometry/mass spectrometry (ESI/MS/MS). Generalized and partial complex seizures, other neurological signs and symptoms, and laboratory data were improved after modification of her anticonvulsant regimen. This is the first report of evaluating the urinary 6beta-hydroxycortisol/cortisol ratio in a case of porphyria.

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“…Cases of AIP in childhood have continued to be reported at intervals [13][14][15][16] , though it may be that the use of diazepam, which is safe, rather than phenobarbitone, for the emergency treatment of seizures, has resulted in fewer instances of children with latent AIP developing symptoms of the disease. An alternative and safe emergency treatment of seizures in AIP is magnesium sulphate 17 .…”

Section: Discussionmentioning

confidence: 99%

Acute intermittent porphyria, seizures, and antiepileptic drugs: a report on a 3-year-old Nigerian boy

Sykes

2001

Seizure

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A 3-year-old Nigerian boy was treated with phenobarbitone after having a nonfebrile seizure. Two weeks later his urine was found to contain porphobilinogen, indicating that latent acute intermittent porphyria had been unmasked by phenobarbitone. The drug was discontinued and carbamazepine was substituted. The urine became free of porphobilinogen and the patient remained well. In developing countries phenobarbitone is the most widely used anticonvulsant; it must be avoided in acute intermittent porphyria, and carbamazepine may be tolerated.

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Aucte intermittent porphyria and epilepsy.

Cited by 13 publications

References 5 publications

Adverse Effects of Valproate

Adverse Effects of Valproate

Microsomal Enzyme Induction and Clinical Aggravation of Porphyria: The Evaluation of Human Urinary 6β‐Hydroxycortisol/Cortisol Ratio as the Index of Hepatic CYP3A4 Activity

Acute intermittent porphyria, seizures, and antiepileptic drugs: a report on a 3-year-old Nigerian boy

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