Decreased serum 24,25-dihydroxyvitamin D concentration during long-term anticonvulsant therapy in adult epileptics

Annals of Neurology
J ZerwekhC Y Pak

Abstract

Serum concentrations of 25-hydroxyvitamin D (25-OHD), 24,25-dihydroxyvitamin D [24,25-(OH)2D], and 1 alpha, 25-dihydroxyvitamin D [1, 25-(OH)2D] were measured in 30 ambulatory adult epileptic patients during long-term anticonvulsant treatment with phenytoin, phenobarbital, or carbamazepine. For the entire group, serum 24,25-(OH)2D was decreased (p less than 0.0005) as compared to normal subjects to a mean value of 0.7 +/- 0.1 (SEM) ng/ml. However, serum 1, 25-(OH)2D was increased at 50 +/- 7 pg/ml (p less than 0.025). Serum 25-OHD declined insignificantly to 19 +/- 3 ng/ml. All three drugs caused a significant reduction of serum 24,25-(OH)2D concentrations. A significant decrease in serum 25-OHD was observed only for the phenobarbital-treated patients. Serum 1, 25-(OH)2D was high in patients receiving phenytoin or carbamazepine but not in those taking phenobarbital. The findings suggest that while various anticonvulsant drugs appear to exert different effects on vitamin D metabolism, a universal finding is diminished serum 24,25-(OH)2D. The results support the notion that 24,25-(OH)2D deficiency may play an important role in the pathogenesis of anticonvulsant-induced osteomalacia.

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Citations

May 18, 2004·Epilepsy & Behavior : E&B·Imran I AliJohn R Gates
Mar 22, 2006·The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists·Michele A FaulknerKayleen Degner
May 8, 2007·Expert Opinion on Drug Safety·Tina GisselPeter Vestergaard
Sep 26, 2013·The International Journal of Neuroscience·András HollóPéter Lakatos
Nov 17, 2009·Clinical Neurology and Neurosurgery·Alberto VerrottiFrancesco Chiarelli
Jan 12, 2013·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Kim RobienJill M Hamilton-Reeves
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Jan 1, 1994·The Annals of Pharmacotherapy·C P Alderman, C L Hill
Feb 17, 2000·The Annals of Pharmacotherapy·Y KaraaslanM Oztürk

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