The Effect of Starvation on the Serum Level of Anticonvulsants in Children

Abstract

To examine the effect of starvation on the serum level of anticonvulsants, the serum concentrations of phenobarbital, phenytoin, carbamazepine, ethosuximide and sodium valproate were measured at frequent intervalsin seven children with epilepsy, aged 4 years and 9 months in average, with body weight of 18.5±4.2 kg (mean± SD), during their 180 hours' total fasting and the following, subsequent peroid of 4: 1 ketogenic diet for the purpose of antiepileptic treatment.
Each patient demonstrated an elevation of the serum levels of anticonvulsants except for carbamazepine during the fast and then a gradual fall to the prefast level by 2 to 3 weeks after starting 4: 1 ketogenic diet.
The elevating effects of starvation on the serum drug levels were thought to be due to delayed drug metabolism in the liver and dehydration by the osmotic diuresis.