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Vitamin D Deficiency in Ambulant Children on Carbamazepine or Sodium Valproate Monotherapy

Mini Sreedharan1, Kalpana Devadathan2, P A Mohammed Kunju1

  • 1Departments of Pediatric Neurology, Government Medical College, Thiruvananthapuram, India.

Indian Pediatrics
|February 12, 2018
PubMed

Insights

Children on carbamazepine (CBZ) or sodium valproate (VPA) for epilepsy have a higher risk of vitamin D deficiency. This study found significantly lower 25-OH vitamin D levels in these pediatric patients compared to controls.

Area of Science:

  • Pediatric Neurology
  • Clinical Chemistry
  • Nutritional Science

Background:

  • Epilepsy is a common neurological disorder in children.
  • Certain antiepileptic drugs, including carbamazepine (CBZ) and sodium valproate (VPA), are known to potentially affect vitamin D metabolism.
  • Vitamin D deficiency can have significant implications for bone health and overall well-being in children.

Purpose of the Study:

  • To evaluate the impact of monotherapy with carbamazepine (CBZ) and sodium valproate (VPA) on serum 25-hydroxyvitamin D [25(OH)D] levels in pediatric epilepsy patients.
  • To compare vitamin D levels in children with epilepsy on CBZ or VPA monotherapy with age-matched healthy controls.

Main Methods:

  • A cross-sectional study was conducted involving children aged 2 to 13 years.
  • Participants included 28 children on CBZ monotherapy, 28 on VPA monotherapy, and 109 healthy controls.
  • Serum 25(OH)D levels and alkaline phosphatase were measured.

Main Results:

  • Children on CBZ and VPA monotherapy exhibited significantly lower median serum 25(OH)D levels (18.0 ng/mL and 21.35 ng/mL, respectively) compared to controls (30.5 ng/mL).
  • A higher prevalence of vitamin D deficiency (25(OH)D levels <20 ng/mL) was observed in children treated with CBZ (60.7%) and VPA (35.7%) compared to controls (27.8%).
  • Elevated serum alkaline phosphatase levels were noted in children receiving carbamazepine therapy.

Conclusions:

  • Monotherapy with carbamazepine or sodium valproate is associated with a significant risk of vitamin D deficiency in children with epilepsy.
  • Monitoring and potential supplementation of vitamin D should be considered for pediatric patients with epilepsy on these antiepileptic drugs.
Abstract

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