Vitamin B12 and Folate Status in Patients with Epilepsy Under Levetiracetam Monotherapy

Atena Mahdavi, Amirmansour Alavi Naeini, Mohammadreza Najaf, Mohammadreza Ghazvini, Mohammadreza Maracy


Background: Antiepileptic drugs (AEDs) may lead to an increase in the plasma concentration of homocysteine. There is limited information, especially from Iran, regarding the risk in patients who are treated with levetiracetam as a new type of AED. The aim of the present study was to investigate
the effect of levetiracetam on plasma homocysteine, vitamin B12, and folate levels in adult patients with epilepsy.

Methods: We conducted a case‑control study and enrolled adult patients with epilepsy who had received monotherapy with levetiracetam for at least 6 months at some time prior to the study. homocysteine serum, vitamin B12, and folate were measured, and folate and vitamin B12 intake was determined by the food frequency questionnaire (FFQ).

Results:Thirty‑three patients on levetiracetam and 35 control subjects aged between 18 and 60 years were enrolled. No statistically signifcant differences in the means of the serum markers of vitamin B12, FA, and homocysteine levels were found between the two groups. In the frst model, i.e., the crude model, no signifcant differences were observed in the serum concentrations of homocysteine, vitamin B12, and folate. In the second model, education was considered, and body mass index and folate intake was controlled with no signifcant difference being observed in the mean homocysteine serum level.

Conclusions:Treatment with levetiracetam in patients with epilepsy has no effect on the serum levels concentrations of homocysteine, vitamin B12, and folate. This medication is suggested for patients who use AEDs on a long‑term basis and at high dosages.

Keywords: Folic acid, levetiracetam, monotherapy, patients with epilepsy, vitamin B12

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