Özben Akıncı GÖKTAŞ, Ayşe Nur COŞKUN, Betül DÜNYA, Aybüke PINAR, Ayşe Derya BULUŞ
Türkiye Çocuk Hastalıkları Dergisi - 2026;20(3):160-165
Objective: This study aimed to evaluate the metabolic and hormonal effects of anti-seizure medications (ASMs) in children with epilepsy by comparing serum levels of vitamin D, calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), vitamin B12, folate, thyroid-stimulating hormone (TSH), and free thyroxine (fT4) between ASM-treated patients and healthy controls. A secondary aim was to investigate differences between patients treated with valproate (VPA) and those treated with levetiracetam (LEV). Materials and Methods: A total of 106 pediatric epilepsy patients undergoing ASM therapy were included in the study, with 93 on monotherapy and 13 on polytherapy for at least six months. Additionally, 80 age- and sex-matched healthy controls were included. Serum biochemical parameters were analyzed retrospectively. Subgroup analyses compared patients on VPA and LEV monotherapy. Statistical comparisons and correlation analyses assessed relationships between drug exposure and biochemical values. Results: Vitamin D levels were significantly lower in ASM-treated patients compared to controls (p<0.001). TSH levels were higher in the VPA group than in the LEV group (p<0.001), although there were no significant differences in thyroid hormone levels between ASM-treated patients and the healthy control group overall. No significant differences were observed in calcium, phosphorus, ALP , vitamin B12, or folate levels between the groups. The duration of ASM use was not correlated with any of the biochemical parameters. Conclusion: Vitamin D deficiency and changes in thyroid function may occur in children treated with ASMs, especially VPA. However, vitamin B12 and folate levels tend to stay stable. Given the ongoing fluctuations in vitamin D and thyroid hormone levels, more frequent monitoring of these parameters may be warranted in pediatric epilepsy patients on ASM therapy. In contrast, less frequent assessment of vitamin B12 and folate may be enough unless there are clinical reasons to test further. More prospective studies are needed to determine the best monitoring approaches.
