Objective: To evaluate the effectiveness of carbamazepine and valproic acid as monotherapy in epileptic patients of Pakhtun population.
Study design: An experimental study.
Place and duration of study: The outpatient Neurology Department, Lady Reading Hospital, Peshawar, from August 2014 to April 2016.
Methodology: Epileptic patients placed on carbamazepine and volproic acid were inducted. Carbamazepine and valproic acid plasma levels were determined using reverse phase high performance liquid chromatography. Plasma levels of vitamin B6 and homocysteine were determined at baseline before the switching to carbamazepine and valproic acid therapy, and on the sixth month of the therapy. Hemoglobin (Hb) level were also determined through blood analyser. Clinical response (number of seizures per week) was evaluated on third and sixth month of the therapy.
Results: There were 79 patients in carbamazepine group and 82 in the valproic acid group. Mean age of patients was 18.08 ±8.6 years in carbamazepine group and 17.5 ±7.04 years in the valproic acid group. Median dose of carbamazepine was 400 mg/day at baseline and at 6th month of therapy. Median dose of valproic acid was 500 mg/day and 750 mg/day of valproic acid at baseline and end study point. Difference in homocysteine, vitamin B6 and Hb levels were statistically significant (p<0.05) in carbamazepine cohort compared to valproic acid cohort. The frequency of seizures in the carbamazepine was 0.85 times more compared to valproic acid at the end study point.
Conclusion: Hyperhomocysteinaemia and lower vitamin B6 and Hb levels was found in the carbamazepine cohort. The frequency of number of seizures/week was higher in the carbamazepine cohort compared to valproic acid cohort.