Evidence supporting the use of: Vitamin B6 (pyridoxal 5-phosphate)
For the health condition: Epilepsy

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Vitamin B6, specifically in its active form pyridoxal 5'-phosphate (PLP), has a scientific basis for use in certain rare forms of epilepsy, particularly pyridoxine-dependent epilepsy (PDE). PDE is a rare, genetic, metabolic disorder typically presenting in neonates or infants, caused by mutations in the ALDH7A1 gene. This leads to a deficiency in the enzyme antiquitin, resulting in accumulation of toxic metabolites that interfere with normal brain function and cause seizures. The seizures in PDE are often resistant to standard antiepileptic drugs but respond dramatically to pharmacological doses of vitamin B6 (either as pyridoxine or PLP). The evidence for this use is well-documented in case reports, clinical series, and mechanistic studies, and vitamin B6 supplementation is the standard of care for PDE. There is also scientific support for its use in other rare B6-responsive epilepsies, such as pyridox(am)ine 5'-phosphate oxidase (PNPO) deficiency. However, outside these specific genetic and metabolic forms, there is little to no evidence supporting vitamin B6 supplementation for the treatment of common epilepsy types. Routine use in generalized or focal epilepsies is not supported by clinical trials. Thus, while scientific evidence strongly supports its use for particular rare epilepsies, it does not generalize to epilepsy as a whole.

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