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Background: The impact of antiepileptics on serum vitamin levels is controversial and uncertain. With no clear conclusion
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 vitamin levels are altered with
antiepileptic drugs or not. 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 at 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.