Chitosan may decrease serum valproate and increase the risk of seizure reappearanceBMJ 2009; 339 doi: http://dx.doi.org/10.1136/bmj.b3751 (Published 24 September 2009) Cite this as: BMJ 2009;339:b3751
- Pasquale Striano, consultant1,
- Federico Zara, consultant1,
- Carlo Minetti, professor of paediatric sciences1,
- Salvatore Striano, professor of neurology2
- 1Unit of Muscular and Neurodegenerative Diseases, “G Gaslini” Institute, University of Genova, Genova
- 2Epilepsy Center, Department of Neurological Sciences, Federico II University, Napoli, Italy
- Correspondence to: Dr Pasquale Striano, Unit of Muscular and Neurodegenerative Diseases, “G Gaslini” Institute, Largo Gaslini 5, 16147-Genova, Italy
- Accepted 2 September 2009
We report two cases of probable interaction between the commonly used anticonvulsant valproate and chitosan, a substance available worldwide to help weight loss.
A 35 year old woman with idiopathic generalised epilepsy, who had not had seizures for three years while taking valproate (500 mg twice/day; 52 μg/ml) and phenobarbital (75 mg/day), had the sudden reappearance of myoclonic jerks, absences, and a tonic-clonic seizure a few days after a dietary supplementation with chitosan (500 mg twice/day) for weight loss. She denied changing her diet and consuming other drugs or natural substances. Seizures remitted after chitosan was stopped. Three months later she …
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