Should vitamin D supplementation routinely be prescribed to children receiving antiepileptic medication?

摘要

Scenario:You are the paediatric registrar at an epilepsy clinic. A mother of a 9-year-old patient with childhood absence epilepsy asks if he should be taking vitamin D. He is currently prescribed sodium valproate. You wonder if you should prescribe vitamin D supplementation alongside his antiepileptic medication.Structured clinical question: In children with a clinical diagnosis of epilepsy on antiepileptic drugs (AED) (population), is there evidence to suggest that they should receive supplemental vitamin D (intervention) to improve their bone health (outcome)? Search:We searched OVID MEDLINE in June 2020 with the keywords (Child OR Paediatrics OR Pediatrics) AND (Vitamin D OR Vitamin D Deficiency OR Cholecalciferol OR Calcitriol) AND (Anti-Epileptic Drug OR Anti-Epileptic Medication OR Anti-Convulsant Drug).The search was limited to articles in English from the year 2000. Sixty-five articles were identified.Twenty articles were included after initial scrutiny and four were selected for full-text review. One further study was identified on review of article references. These were graded according to the Oxford level of evidence (table 1).1