Shaikh Abdul S, Guo Xi, Li Yi, Cao Lili, Liu Xuewu, Li Pingli, Zhang Rui, Guo Ruichen
Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan, China.
Department of Pharmacy, Shah Abdul Latif University, Khairpur, Pakistan.
Curr Pharm Biotechnol. 2018;19(8):674-681. doi: 10.2174/1389201019666180816104716.
The impact of antiepileptics on serum vitamin levels is controversial and uncertain. With no clear conclusions 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.
The intention of the present research is to confirm the hypothesis of whether or not vitamin levels are altered with antiepileptic drugs. 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.
The present research was piloted in collaboration with the Department of Neurology in 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.
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.
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.
抗癫痫药物对血清维生素水平的影响存在争议且尚不明确。由于抗癫痫药物对血清维生素水平的影响尚无明确结论，因此需要进一步开展临床研究，以确定新旧抗癫痫药物对癫痫患者血清维生素水平的影响，从而实现维生素补充剂的合理使用。
本研究旨在证实抗癫痫药物是否会改变维生素水平这一假设。该研究还旨在揭示哪些维生素水平变化尤为明显，维生素水平是否受性别以及所用抗癫痫药物的类型和数量影响。
本研究与山东大学齐鲁医院神经内科合作开展。共采集了63例接受单药治疗或联合治疗的癫痫患者的血清样本，用于分析9种血清维生素水平。对接受抗癫痫药物治疗的癫痫患者的9种维生素（维生素B1、B2、B6、B9、B12、A、C、D和E）进行了分析。所有维生素的血清检测结果经SPSS软件汇总并评估。
令人担忧的是，本研究中几乎所有（90%）癫痫患者的血清维生素D水平都特别低。值得注意的是，分别有72%和46%的癫痫患者的血清维生素C和维生素B1水平也低于参考范围。其余维生素在大多数患者中几乎都处于参考范围内。在我们的研究中，不同性别组中维生素D、C和B1水平的均值和频率差异不大。与接受旧抗癫痫药物的患者相比，接受新抗癫痫药物的患者血清维生素D水平略有升高。我们发现，与联合治疗的患者相比，接受单药治疗的患者血清维生素D、C和B1水平较低。
本研究最显著且令人惊讶的发现是，几乎所有患者的血清维生素D水平都特别低，部分患者的血清维生素B1水平也低于参考范围。更重要的是，本研究首次报道，大多数中国癫痫患者的血清维生素C水平也低于参考范围。建议除了对抗癫痫药物进行治疗药物监测外，还应定期监测所有这些维生素。需要进一步开展临床试验进行评估。还建议对这些维生素血清水平低的癫痫患者，可在使用抗癫痫药物的同时开具维生素补充剂处方，以便更有效且高效地控制其癫痫发作。
