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

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Synopsis

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

Vitamin B6, in its active form pyridoxal 5'-phosphate (PLP), has a scientifically validated role in the treatment of certain seizure disorders, particularly those caused by pyridoxine-dependent epilepsy (PDE). PDE is a rare genetic disorder that manifests as early-onset, intractable seizures that do not respond to standard anticonvulsant therapies. The underlying cause is a deficiency in the enzyme antiquitin (ALDH7A1), leading to impaired metabolism of lysine and accumulation of metabolites that inactivate PLP, which is essential for neurotransmitter synthesis, especially gamma-aminobutyric acid (GABA), a major inhibitory neurotransmitter in the brain. Without adequate PLP, GABA synthesis is compromised, resulting in increased neuronal excitability and seizures. Numerous case reports and clinical studies have established that administration of high-dose pyridoxine (vitamin B6) or directly of PLP can stop seizures in affected infants, often within hours. As such, prompt recognition and supplementation are life-saving for individuals with PDE and related metabolic epilepsies (e.g., pyridoxamine 5'-phosphate oxidase deficiency). For the general population or other causes of epilepsy, however, there is no strong evidence supporting vitamin B6 supplementation as an effective treatment. Therefore, while the use is strongly justified and evidence-based in specific genetic/metabolic seizure disorders, it is not generally applicable to all seizure types.

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