Biotin catabolism is accelerated in adults receiving long-term therapy with anticonvulsants

Neurology. 1997 Nov;49(5):1444-7. doi: 10.1212/wnl.49.5.1444.


Using serum biotin concentration as the indicator, a previous study reported biotin deficiency resulting from long-term anticonvulsant therapy. However, serum biotin may not be a good indicator of tissue biotin status. Using better indicators of biotin status in anticonvulsant-treated subjects, we found increased urinary excretion of biotin catabolites and 3-hydroxyisovaleric acid, an organic acid produced in greater quantities secondary to reduced activity of a biotin-dependent carboxylase. We conclude that anticonvulsant treatment led to increased biotin catabolism and probably to reduced biotin status.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Anticonvulsants / metabolism*
  • Anticonvulsants / therapeutic use*
  • Biotin / analogs & derivatives
  • Biotin / blood
  • Biotin / metabolism*
  • Biotin / urine
  • Epilepsy / drug therapy*
  • Epilepsy / metabolism*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Time Factors
  • Valerates / blood
  • Valerates / urine


  • Anticonvulsants
  • Valerates
  • bisnorbiotin
  • beta-hydroxyisovaleric acid
  • Biotin