Posted by Larry Hoover on November 17, 2008, at 22:41:21
In reply to Lamictal and Folate Deficiency, posted by bulldog2 on November 17, 2008, at 16:03:33
> I have currently started lamictal at 25 mg and will be slowly titrating up to 100 mg. I've read that lamictal can interfere with the synthesis of folate. Any suggestions as to how much folate would be needed as an adjunct. I have a script for deplin but 7.5 mg of folate might be overkill. Currently not on deplin but trying nac and sometimes sam-e.
Lamictal is a rather modest inhibitor of the enzyme dihydrofolate reductase, which completes the two-step activation of dietary folate into the bioactive form, tetrahydrofolate. I can't find very much evidence that the effect is of clinical significance in humans, although it has been shown to cause serious problems in lab rats.
Deplin would totally bypass the concern, as it is already biologically active, and downstream from the potentially inhibited enzyme. However, because the inhibition of dihydrofolate reductase appears to be incomplete, an oral folate supplement would still boost the yield from that enzyme. I would think that the common folate supps @ e.g. 400 mcg would cover any possible effect of the Lamictal.
A B-12 deficiency would increase the adverse effect potential of the Lamictal, as would a B-6 deficit, so it might be advisable to use a B-complex supp....just to cover all bases.
Regards,
Lar
poster:Larry Hoover
thread:863630
URL: http://www.dr-bob.org/babble/20081114/msgs/863719.html