Macrocytosis in Patients on Anticonvulsant Drugs

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Abstract
Summary: Blood from 100 patients taking anticonvulsant drugs was examined and a high mean cell volume (MCV) was found in 8 per cent, a low folate in 27 per cent and macrocytosis on a peripheral blood smear in 18 per cent. In 10 of 11 patients with a high or high‐normal MCV, there was a fall in MCV following treatment with oral folic acid; there was no increase in the frequency of convulsions and an improvement in mental condition was noted in five of the 11 cases. It is suggested that, whereas minor disturbances of folic‐acid metabolism may be common in patients taking anticonvulsant drugs, when a major dyscrasia occurs, additional factors, for example dietary deficiency, should be sought.