Title:The Impact of Antiepileptic Drugs on Vitamin Levels in Epileptic Patients
VOLUME: 19 ISSUE: 8
Author(s):Abdul S. Shaikh, Xi Guo, Yi Li, Lili Cao, Xuewu Liu, Pingli Li, Rui Zhang and Ruichen Guo*
Affiliation:Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan, Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan, Department of Neurology, Qilu Hospital of Shandong University, Jinan, Department of Neurology, Qilu Hospital of Shandong University, Jinan, Department of Neurology, Qilu Hospital of Shandong University, Jinan, Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan, Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan, Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan
Keywords:Antiepileptics, vitamins, vitamin D, polytherapy, serum levels, levetiracetam.
Abstract:Background: The impact of antiepileptics on serum vitamin levels is controversial and uncertain.
With no clear conclusions on the impact of antiepileptics on serum levels of vitamins, there is
a need for further clinical studies in order to ascertain the impact of old and newer antiepileptic drugs
on serum levels of vitamins in epileptic patients, thus accomplishing a suitable usage of vitamins supplementation.
Objective: The intention of the present research is to confirm the hypothesis of whether or not vitamin
levels are altered with antiepileptic drugs. The study also aims to reveal which vitamin levels are particularly
more altered, are vitamin levels affected by gender and the type and number of antiepileptics used.
Methods: The present research was piloted in collaboration with the Department of Neurology in Qilu
Hospital of Shandong University. A total of 63 serum samples of epileptic patients receiving antiepileptics
as monotherapy or polytherapy were requested for analysis of nine vitamin serum levels. Total
nine vitamins (B1, B2, B6, B9, B12, A, C, D and E) in epileptic patients receiving antiepileptic drugs
were analyzed. The serum results of all vitamins were compiled and evaluated with SPSS.
Results: It was alarmingly found that serum levels of vitamin D were particularly very low in almost
all (90%) epileptic patients in this study. Notably, serum levels of vitamin C and vitamin B1 were also
below reference range in 72% and 46% epileptic patients, respectively. The remaining vitamins were
almost in reference range for most of the patients. In our study, mean and frequency of vitamin D, C
and B1 levels do not vary too much among different gender groups. The patients receiving newer
antiepileptic drugs displayed a slightly increased serum vitamin D levels in comparison to the patients
receiving older antiepileptic drugs. We found low vitamin D, C and B1 serum levels in patients who
were on monotherapy as in comparison with patients on polytherapy.
Conclusion: The most significant and surprising finding of this study revealed that serum vitamin D levels
in particular were very low in almost all patients and in some patients’ vitamin B1 serum levels were
also below the reference range. More importantly, it is first time reported here that vitamin C serum levels
were also below reference range in the majority of these Chinese epileptic patients. It is recommended
that all these vitamins should be regularly monitored in addition to therapeutic drug monitoring of antiepileptic
drugs. Additional clinical trials are required for further evaluation. It is also recommended that epileptic
patients with low serum levels of these vitamins may be prescribed vitamins supplementations with
antiepileptic drugs in order to control their seizures more effectively and efficiently.
