Effect of Anti-Seizure Medication Monotherapy on Vitamin D Levels in Indian Children: A Longitudinal Cohort Study.

BACKGROUND AND PURPOSE: The timeline of alteration of vitamin D and calcium levels in those receiving anti-seizure medication (ASM) remains to be elucidated. To determine the changes in vitamin D levels over a period of 6 months among children receiving monotherapy with commonly used ASM.

METHODS

The baseline serum levels of vitamin D, parathyroid hormone (PTH), calcium, alkaline phosphatase (ALP), phosphorus were measured in 32 children (median age 8 years) with newly diagnosed epilepsy. An appropriate ASM monotherapy was started. Those found to be deficient were treated with vitamin D supplementation. Children were reassessed after 90 days and 180 days for drug compliance and drug side-effects. All the baseline investigations were repeated.

RESULTS

At baseline, 21.9% of children were vitamin D-deficient, with a median serum level of 19.8 ng/mL. For children who were not vitamin D-deficient (VDD) at baseline (n=25), the median (interquartile range [IQR]) vitamin D levels were found to be significantly lower than baseline after 90 days of ASM use (23.0 [18.0 to 28.9] vs. 22.0 [12.0 to 24.0]; p<0.001). After 90 days, ASMs caused notable decreases in vitamin D levels from baseline for children who were not VDD at baseline (n=25) (23.0 [18.0 to 28.9] vs. 22.0 [12.0 to 24.0]; p<0.001), alongside changes in calcium, phosphorus, PTH and ALP levels. Similarly, in children who were non-deficient at 90 days follow-up (n=20), median (IQR) vitamin D levels were found to be significantly lower at 180 days than at 90 days (24.5 [21.0 to 28.9] vs. 18.4 [13.6 to 20.6]; p<0.001).

CONCLUSIONS

The study noted vitamin D deficiency in children on ASM monotherapy for 3-6 months, emphasizing regular monitoring by clinicians.