Folic Acid and Anticonvulsive Drugs

IN RECENT years there has been an increasing interest in the possible interplay between folic acid and anticonvulsive drugs. Subnormal serum folate levels have been found in a large number of patients treated with anticonvulsive drugs (Klipstein,1Reynolds et al,2Reynolds,3and Ibbotson et al4). However, Weckman and Lehtovaara5did not find any significant difference between the serum folate levels of a group of treated epileptics and a group of nontreated normal control subjects. Furthermore, about 50 cases are reported in which antiepileptic drugs are stated as the causative agents of a folic acid deficiency resulting in megaloblastic anemia (review by Stokes and Fortune6). In various reports, Reynolds7has put forward the hypothesis that the presumed forlicacid deficiency may cause dementia and schizophrenia-like psychoses in patients with epilepsy. Also, Strachan and Henderson8maintain that folic acid deficiency may give rise to