Effect of Daily Vitamin D Supplementation on Serum Vitamin D Levels in Children with Epilepsy Receiving Sodium Valproate Monotherapy: A Randomized, Controlled Trial

Indian J Pediatr. 2023 May;90(5):450-456. doi: 10.1007/s12098-022-04225-w. Epub 2022 Jun 28.

Abstract

Objectives: To compare the change in serum vitamin D levels and to compare the changes in serum levels of calcium, phosphate, alkaline phosphatase and parathyroid hormone in vitamin D supplemented and unsupplemented groups after 3 mo.

Methods: In this randomized, parallel group, nonblinded, controlled trial, 40 children, 2-12 y of age with newly diagnosed epilepsy, and vitamin D sufficient status, and started on valproate monotherapy, were randomized into the intervention group (n = 20), which was given daily oral 600 IU vitamin D supplementation, and the control group (n = 20), which was not given any supplementation. Changes in the biochemical parameters was measured in the two groups after 3 mo.

Results: There was a significant reduction in the median (IQR) vitamin D levels in the control group as compared to an increase seen in the intervention group [-6.64 (-8.4, -2.65) vs. 5.66 (1.81, 7.12); p < 0.001]. In the control group, 37.5% children developed vitamin D insufficiency and 12.5% developed deficiency whereas only 5% of the intervention group developed vitamin D insufficiency (p = 0.005). There was a significant decrease in ionized calcium (p = 0.02), increase in serum phosphate (p = 0.02), and alkaline phosphatase level (p = 0.003) in the unsupplemented group as compared to the supplemented group.

Conclusion: Vitamin D supplementation can reduce the valproate-associated decline in vitamin D levels and the negative impact on other markers of bone mineral metabolism.

Trial registration: TCTR20200621002, 19.06.2020, retrospectively registered.

Keywords: Adverse effect; Antiseizure medication; Osteomalacia; Prevention; Rickets.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Alkaline Phosphatase
  • Calcium
  • Child
  • Dietary Supplements
  • Epilepsy* / drug therapy
  • Humans
  • Parathyroid Hormone
  • Phosphates
  • Valproic Acid / therapeutic use
  • Vitamin D
  • Vitamin D Deficiency*
  • Vitamins / therapeutic use

Substances

  • Vitamin D
  • Valproic Acid
  • Calcium
  • Alkaline Phosphatase
  • Vitamins
  • Parathyroid Hormone
  • Phosphates