Assessing the impact of levetiracetam and sodium valproate monotherapy on serum 25-hydroxy vitamin D levels in pediatric epilepsy: Insights from a leading tertiary care hospital in Haldwani

Background: Epilepsy, as a prevalent chronic neurological disorder, requires prolonged therapeutic interventions, which may expose pediatric patients undergoing anticonvulsant treatment to potential risks associated with Vitamin D deficiency and compromised bone health. This research delves into the impact of Levetiracetam (LEV) and Sodium Valproate (VPA), two commonly prescribed antiepileptic medications, on bone health. Aims and Objectives: To study the effects of LEV and sodium VPA monotherapy on serum 25-hydroxy vitamin D levels in pediatric patients with epilepsy (1–16 years). Materials and Methods: Within a prospective interventional investigation, a total of 148 newly diagnosed pediatric epilepsy patients aged between 1 and 16 years were recruited and segregated into two cohorts: One administered LEV (n=74) and the other receiving Sodium VPA (n=74). The study assessed serum Vitamin D levels, in conjunction with Calcium, Phosphorous, and ALP, both before and after a 6 months period of monotherapy. Results: Following the intervention, it was observed that 72.9% of patients treated with Sodium VPA demonstrated a decline in Vitamin D levels, among whom 24.3% displayed significant Vitamin D insufficiency (P<0.001). In contrast, 43.2% of individuals receiving LEV exhibited decreased Vitamin D levels, with only 6.2% manifesting Vitamin D insufficiency (P=0.004), indicating a comparatively milder impact on bone health. Conclusion: The findings suggest that Sodium VPA monotherapy substantially disrupts bone metabolism when juxtaposed with LEV, thus implying that the latter may represent a safer alternative concerning bone health. This study accentuates the critical importance of routine monitoring of Vitamin D levels and potential supplementation for pediatric patients undergoing treatment with Sodium VPA to alleviate the associated bone health hazards.