Home > Medical Reference > Complementary Medicine

Disclaimer

Note: The resources listed in this guide are not intended to be fully systematic or complete, nor does inclusion here imply any endorsement or recommendation by The University of Maryland or the Center for Integrative Medicine. The University of Maryland and the Center for Integrative Medicine make no warranties, express or implied, about the value or utility for any purpose of the information and resources contained herein.

Anticonvulsant medications - valproic acid derivatives

Medications:

Valproic Acid and Derivatives
- Depacon
- Depakene
- Depakote Delayed Release
- Depakote ER

Depletions:

Carnitine (L-Carnitine)

Although carnitine is made by the body, deficiency can occur and may be associated with anemia, fatigue, increased blood levels of ammonia, lethargy, unexplained stupor, and heart irregularities.

Copper

Although copper deficiency is rare, signs and symptoms of long term depletion of copper include anemia, changes in the structure and appearance of hair, heart damage, growth retardation, impaired bone formation, osteoporosis (bone loss), and emphysema (lung disease).

Selenium

Selenium deficiency may be associated with muscular, digestive, and heart disorders; long-term deficiency may be associated with increased risk of developing certain chronic illnesses such as cancer, diabetes, or liver disease.

Vitamin B9 (Folic Acid)

Low levels of folic acid have been linked to anemia, heart disease, and birth defects.

Zinc

Signs and symptoms of zinc deficiency include loss of appetite or sense of taste, growth retardation, skin changes, and increased susceptibility to infection.

Editorial Note:

The selected depletions information presented here identifies some of the nutrients that may be depleted by certain medications. The signs and symptoms associated with nutrient deficiency may also indicate conditions other than nutrient deficiency. If you are experiencing any of the signs or symptoms mentioned, it does not necessarily mean that you are nutrient deficient. Nutrient depletion depends upon a number of factors, including your medical history, diet, and lifestyle, as well as the length of time you have been taking the medication. Please consult your health care provider; he or she can best assess and address your individual health care needs, and determine if you are at risk for nutrient depletions from these medications, as well as others not listed here.

Reviewed last on: 4/19/2010
Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed HealthCare Network.

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.

Castro-Gago, M, Eiris-Punal J, Novo-Rodriguez MI, et al. Serum carnitine levels in epileptic children before and during treatment with valproic acid, carbamazepine, and phenobarbital. J Child Neurol. 1998;13(11):546-549.

Chung S, Choi J, Hyun T, Rha Y, Bae C. Alterations in the carnitine metabolism in epileptic children treated with valproic acid. JKMS. 1997;12:553-558.

Coulter DL. Carnitine, valproate, toxicity. J Child Neurol. 1991;61(1):7-14.

Donnelly PS, Xiao Z, Wedd AG. Copper and Alzheimer's disease. Curr Opin Chem Biol. 2007;11(2):128-33.

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

Goggin T, Gough H, Bissessar A, et al. A comparative study of the relative effects of anticonvulsant drugs and dietary folate on the red cell folate status of patients with epilepsy. Q J Med. 1987;65(247):911-919.

Graf WD, Oleinik OE, Glauser TA, et al. Altered antioxidant enzyme activities in children with a serious adverse experience related to valproic acid therapy. Neuropediatr. 1998;29(4):195-201.

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

Hurd RW, Rinsvelt HA, Wilder RJ, et al. Selenium, zinc, and copper changes with valproic acid: possible relation to drug side effects. Neurol. 1984;34(10):1393-1395.

Kaji M, Ito M, Okuno T, et al. Serum copper and zinc levels in epileptic children with valproate treatment. Epilepsia. 1992;33(3):555-557.

Lerman-Sagie T, Statter M, Szabo G, et al. Effect of valproic acid therapy on zinc metabolism in children with primary epilepsy. Clin Neuropharmacol. 1987;10(1):80-86.

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.

Sozuer DT, Baruteu UB, Karakoe Y, et al. The effects of antiepileptic drugs on serum zinc and copper levels in children. J Basic Clin Physiol Pharmacol. 1995;6(3-4):265-269.

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].

Van Wouwe JP. Carnitine deficiency during valproic acid treatment. Int J Vitam Nutr Res. 1995;65(3):211-214.

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.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Connect with UMMC

© 2011 University of Maryland Medical Center (UMMC). All rights reserved.
UMMC is a member of the University of Maryland Medical System,
22 S. Greene Street, Baltimore, MD 21201. TDD: 1-800-735-2258 or 1.800.492.5538