{"doi":"10.1111/epi.18046","title":"Vitamin D prophylaxis in persons with epilepsy?","abstract":"<jats:title>Abstract</jats:title><jats:p>Limited guidelines exist regarding osteoporosis prevention in the general population. Despite being a subject of controversy, the majority of research suggests that decreased vitamin D levels correlate with increased bone turnover, that is, an important risk factor for osteoporosis development. In most guidelines, daily vitamin D supplementation is recommended. In persons with epilepsy (PWE), the situation is more complex, as other factors can increase the chance of being vitamin D deficient. Currently, there are no internationally accepted guidelines regarding monitoring bone health in PWE. Our aim was to review the existing evidence in PWE on: (1) risk factors for vitamin D deficiency, (2) the identification of higher risk groups, and (3) the optimal ways to monitor bone health. Our narrative review shows that: (1) anti‐seizure medication (ASM) use, especially enzyme‐inducing ASM (EIASM) and valproic acid, is identified as an important risk factor for impaired bone health (e.g., increased risk for osteoporosis/fractures and/or vitamin D deficiency); (2) higher risk groups within the PWE population are present: intellectual or physical disability, institutionalized patients, puberty, early onset epilepsy and developmental epileptic encephalopathies, postmenopausal women, and use of multiple ASM/concomitant drugs (e.g. corticosteroids); and (3) a monitoring scheme can be suggested including laboratory tests, bone density measurements, managing of risk factors, and/or vitamin D supplementation. Overall, regular vitamin D measurement in PWE is a cost‐effective and practical method for monitoring vitamin D deficiency, whereas in high‐risk patients the combination of vitamin D measurement and bone densitometry is recommended. There is not enough evidence to advocate continuous vitamin D supplementation in all PWE. Children with epilepsy should receive the recommended daily intake of vitamin D for age and additional monitoring and supplementation if at higher risk of deficiency. There is a need for prospective trials exploring the potential benefit of vitamin D supplementation in PWE.</jats:p>","journal":"Epilepsia","year":2024,"id":674115,"datarank":0.3453877639491069,"base_score":2.302585092994046,"endowment":2.302585092994046,"self_citation_contribution":0.3453877639491069,"citation_network_contribution":0.0,"self_endowment_contribution":0.3453877639491069,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":9,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":236842,"name":"Stéphane Auvin","orcid":"0000-0003-3874-9749","position":1,"is_corresponding":false},{"id":841619,"name":"Leonor Cabral‐Lim","orcid":"0000-0002-7523-4165","position":2,"is_corresponding":false},{"id":1761299,"name":"Anita Devlin","orcid":null,"position":3,"is_corresponding":false},{"id":1761300,"name":"Dennis Dluglos","orcid":null,"position":4,"is_corresponding":false},{"id":1761301,"name":"Hassan Hosny","orcid":null,"position":5,"is_corresponding":false},{"id":1761302,"name":"Tony Marson","orcid":null,"position":6,"is_corresponding":false},{"id":339592,"name":"Kimford J. Meador","orcid":"0000-0002-7471-882X","position":7,"is_corresponding":false},{"id":262425,"name":"Archana A. Patel","orcid":"0000-0002-1159-0128","position":8,"is_corresponding":false},{"id":1761303,"name":"Page B. Penell","orcid":null,"position":9,"is_corresponding":false},{"id":476255,"name":"Kate Riney","orcid":"0000-0002-1122-3555","position":10,"is_corresponding":false},{"id":614731,"name":"Eugen Trinka","orcid":"0000-0002-5950-2692","position":11,"is_corresponding":false},{"id":838934,"name":"Samuel Wiebe","orcid":"0000-0002-1061-9099","position":12,"is_corresponding":false},{"id":864885,"name":"Lieven Lagae","orcid":"0000-0002-7118-0139","position":13,"is_corresponding":false},{"id":1513971,"name":"Jo Sourbron","orcid":"0000-0002-5319-6495","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Vitamin D prophylaxis in persons with epilepsy?","abstract":"<jats:title>Abstract</jats:title><jats:p>Limited guidelines exist regarding osteoporosis prevention in the general population. Despite being a subject of controversy, the majority of research suggests that decreased vitamin D levels correlate with increased bone turnover, that is, an important risk factor for osteoporosis development. In most guidelines, daily vitamin D supplementation is recommended. In persons with epilepsy (PWE), the situation is more complex, as other factors can increase the chance of being vitamin D deficient. Currently, there are no internationally accepted guidelines regarding monitoring bone health in PWE. Our aim was to review the existing evidence in PWE on: (1) risk factors for vitamin D deficiency, (2) the identification of higher risk groups, and (3) the optimal ways to monitor bone health. Our narrative review shows that: (1) anti‐seizure medication (ASM) use, especially enzyme‐inducing ASM (EIASM) and valproic acid, is identified as an important risk factor for impaired bone health (e.g., increased risk for osteoporosis/fractures and/or vitamin D deficiency); (2) higher risk groups within the PWE population are present: intellectual or physical disability, institutionalized patients, puberty, early onset epilepsy and developmental epileptic encephalopathies, postmenopausal women, and use of multiple ASM/concomitant drugs (e.g. corticosteroids); and (3) a monitoring scheme can be suggested including laboratory tests, bone density measurements, managing of risk factors, and/or vitamin D supplementation. Overall, regular vitamin D measurement in PWE is a cost‐effective and practical method for monitoring vitamin D deficiency, whereas in high‐risk patients the combination of vitamin D measurement and bone densitometry is recommended. There is not enough evidence to advocate continuous vitamin D supplementation in all PWE. Children with epilepsy should receive the recommended daily intake of vitamin D for age and additional monitoring and supplementation if at higher risk of deficiency. There is a need for prospective trials exploring the potential benefit of vitamin D supplementation in PWE.</jats:p>","is_dataset_classified":null,"base_score":2.1972245773362196,"endowment":2.1972245773362196,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"39494692","pmcid":null,"openalex_id":"https://openalex.org/W4399923125","authors":[],"funders":[],"total_grants":0,"fwci":7.1265,"citation_percentile":0.96643428,"influential_citations":0,"citation_trend":[{"year":2025,"count":3},{"year":2026,"count":5}],"oa_status":"closed","license":"http://onlinelibrary.wiley.com/termsAndConditions#vor","oa_locations":[{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/epi.18046","host_type":"publisher"},{"url":"https://doi.org/10.1111/epi.18046","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/39494692","host_type":"repository"}],"fields_of_study":["Pharmacological Effects and Toxicity Studies","Vitamin D Research Studies","Epilepsy research and treatment","Humans","Epilepsy","Vitamin D Deficiency","Vitamin D","Anticonvulsants","Osteoporosis","Risk Factors","Bone Density","Female"],"mesh_terms":["Anticonvulsants","Epilepsy","Female","Humans","Osteoporosis","Risk Factors","Vitamin D","Vitamin D Deficiency","Bone Density"],"keywords":["Epilepsy","Medicine","Vitamin D and neurology","Pediatrics","Psychiatry","Monitoring","Osteoporosis","risk factors","Supplementation","Bone Health"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-16T15:39:23.111898Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}