Understanding George III’s Ailment

ing George III had it, and it caused madness. When epilepsy patients suffer from it, it’s often triggered by seizure drugs. The disease is porphyria, an uncommon genetic disorder that can be latent in some people. But when it’s sparked, porphyria causes severe build-up of toxins from disruption of liver metabolism. In a recently published case study of an epilepsy patient who had developed severe skin and liver damage, neurologist Gregory Krauss, M.D., reported that the standard drug, phenytoin, was prompting the symptoms of her porphyria. In fact, he says, that’s the danger with many traditional anticonvulsants as well as many of the new, heavily publicized epilepsy medications finding their way into the neurologist’s arsenal.

“There’s a real problem when this side effect crops up,” says Krauss. “All the older seizure drugs and most of the new seizure drugs cause this problem.” The woman’s situation led Krauss to laboratory tests where he scrutinized the effects of six new epilepsy medications. Of those drugs, he found four are likely to cause porphyria; two are safe. “Sensitive animal testing shows neither vigabatrin nor gabapentin triggers porphyria, while others cause massive porphyria elevations,” Krauss says. For the patient in the study, he emphasizes, “changing her medication caused the disease to disappear completely.”