Unraveling the nutritional challenges in epilepsy: Risks, deficiencies, and management strategies: A systematic review

Table 6 The effects of some antiepileptic drugs on the nutritional status of individuals with epilepsy

Drug class/drug	Nutrient affected	Effect on nutrient	Potential side effects and consequences	Recommendations
Enzyme-inducing antiepileptic drugs
Phenytoin (Dilantin)	B1, B2, B3, B6, B12, Biotin, Folic Acid, K, Calcium, Vitamin D	Decreased absorption and metabolism, increased excretion	Nerve damage, fatigue, skin problems, anemia, developmental problems	Supplementation with affected vitamins, calcium and vitamin D, monitoring bone density
Carbamazepine (Tegretol), Oxcarbazepine (Trileptal)	B1, B2, B3, B6, B12, folic acid, calcium, Vitamin D	Decreased absorption and metabolism, increased excretion	Like phenytoin	Similar recommendations as phenytoin
Phenobarbital (Luminal)	B1, B2, B3, B6, B12, Folic Acid, Calcium, Vitamin D	Increased metabolism, decreased absorption	Like phenytoin, it may also cause drowsiness and cognitive problems	Similar recommendations as phenytoin, with additional monitoring for cognitive function
Non-enzyme-inducing antiepileptic drugs
Levetiracetam (Keppra)	B12	Decreased absorption	Anemia, nerve damage, generally well-tolerated, limited impact on nutrition	Supplementation with B12
Lamotrigine (Lamictal)	Bone metabolism	Potential impairment	Bone loss, osteoporosis	Calcium and vitamin D supplementation, monitoring bone density
Topiramate (Topamax)	Weight, Glucose metabolism	Potential increase or decrease, possible impairment	Weight gain or loss, diabetes, altered taste perception	Dietary adjustments, monitoring weight and blood sugar
Valproic acid (Depakote)	Weight, lipid metabolism	Potential increase	Increased risk of weight gain, altered lipid metabolism	Dietary adjustments, monitoring weight
Gabapentin	Weight	Potential increase	Minimal impact on nutrition, some reports of weight gain	Dietary adjustments, monitoring weight
Pregabalin	Weight, appetite	Potential increase	Weight gain, potential alterations in appetite	Dietary adjustments, monitoring weight