Effects of sodium valproate and levetiracetam monotherapy on vitamin D status in epileptic children: A study from Eastern India

Objectives: To compare serum vitamin D levels of paediatric epilepsy patients treated with valproic acid or levetiracetam monotherapy with those of age and sex matched controls.

Method: An analytical, cross-sectional study was carried out in a tertiary care hospital in eastern India. Sixty children aged 2-12 years with idiopathic epilepsy, on either sodium valproate or levetiracetam monotherapy for 6 months or more were included in this study and 30 age and sex matched healthy children were taken as controls. Children having calcium or vitamin D supplementation, children on two or more antiepileptic drugs and children on any chronic medication which can affect bone metabolism were excluded from this study. Serum 25-hydroxy vitamin D concentrations of >20 ng/ml was taken as vitamin D sufficiency, from 12-20 ng/ml as vitamin D insufficiency and <12 ng/ml as vitamin D deficiency.

Results: Of the 60 patients included in the study 42 (70%) were males and 18 (30%) were females. Among the 30 control 8 (60%) were males and 12 (40%) were females. Patients receiving sodium valproate and levetiracetam therapy had mean serum 25-hydroxy vitamin D levels of 15.54±10.05 ng/ml and 14.54±8.68 ng/ml respectively. Among controls, mean serum 25-hydroxy vitamin D level was 21.09±4.79 ng/ml. Sodium valproate group (p < 0.001) and levetiracetam group (p = 0.003) had significantly lower serum 25-hydroxy vitamin D levels than the control group.

Conclusion: Sodium valproate and levetiracetam monotherapy were significantly associated with hypovitaminosis D. Duration of valproate therapy had a negative correlation with the serum vitamin D level.

Sri Lanka Journal of Child Health, 2022; 51(3): 364-368