Dilantin and Folate

[veryniceguy_]

I've read about the two-way interaction between dilantin and folate, and am confused. I've been on Dilantin for 15 months, and when I raised concerns about its depleting effect on folate, my doctor recommended taking a daily vitamin pill as a supplement. Im male, 44, and my folate levels are currently normal. I worry that adding folate will accelerate the dilantin metabolism and make me prone to breakout seizures (I haven't had a seizure since I went on the medication. I had a GM seizure two years after surgery to remove an AVM).

Should I take the vitamin or not? Also, is it worth having homocystein levels tested, and should a bone scan be done to establish a baseline to monitor future bone density losses from dilantin?
Thanks

[CCF-Neuro-M.D.-JT]

Taking folate will NOT interfere with the antiseizure properties of dilantin. You likely need an antiepileptic med  on board given your neurological history, but it's your choice as to whether or not you want to take the folate. It's a relatively safe supplement and should not have any side effects if taken as directed (1mg a day). Also, checking homocysteine levels and bone density scans are not tests that we routinely order for patients on dilantin.  In the past, we have ordered homocysteine levels for patients needing dilantin and who have risk factors such as those with a personal or family history of early coronary disease or strokes.  And in those particular patients as well as some others we have recommended the folate supplement. Ultimately, it's a decision you and your doctor should make.  In simple terms: the folate may help and it won't hurt. Good luck.

[dizz]

I have done a bit of research on Folic Acid or Folate as my Neuro at UCSF had prescribed it to me after my stroke (1mg/day). Before taking any new meds I consulted my regular Neuro and PCP. My regular Neuro said take it, I then asked my PCP what it did and he said "I don't know" (boy am I in trouble, pretty bad when you have to look it up yourself hehehe), but from what I've been able to assertain, there are no ill gotten effects of Folate other than masking symptoms of Vitamin B-12 deficentcy which can be a more serious problem. Don't forget to take care of them vessels keeping the flexible by making sure your not low on vitamin-C.

below is a link to more info on Folate (Folic Acid):
http://vvv.com/healthnews/folate.html