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

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Vitamin B6, specifically in its active form pyridoxal 5’-phosphate (PLP), has a well-established scientific basis for use in the management of certain seizure disorders, most notably pyridoxine-dependent epilepsy (PDE). PDE is a rare, autosomal recessive disorder caused by mutations in the ALDH7A1 gene, which result in a deficiency of PLP, a cofactor essential for the synthesis of neurotransmitters such as gamma-aminobutyric acid (GABA). GABA is the primary inhibitory neurotransmitter in the central nervous system, and its deficiency leads to neuronal hyperexcitability and seizures, often presenting in the neonatal period or early infancy.

Administration of Vitamin B6 (as pyridoxine or PLP) can rapidly and dramatically control seizures in affected individuals, making it a life-saving therapy in this specific context. The diagnosis is typically confirmed by genetic analysis and biochemical testing, but empiric treatment with Vitamin B6 is often initiated in neonates with unexplained, intractable seizures due to the potential for immediate benefit. For other types of seizures or epilepsy not related to pyridoxine dependency, there is little robust evidence supporting Vitamin B6 supplementation as an effective therapy, and its use is not standard practice.

Therefore, the use of pyridoxal 5’-phosphate for treating seizures is scientifically validated, but primarily for rare, specific metabolic epilepsies such as pyridoxine-dependent epilepsy, not for generalized or idiopathic seizure disorders.

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