Do antiepileptics have any potential to induce insulin resistance? A comparison between levetiracetam and valproic acid

Abstract

Objective: To explore whether levetiracetam and valproic acid are associated with insulin resistance and todetermine their effects on glucose and insulin levels among different age groups.Methods: Demographic data were collected for epileptic patients from different age groups with a normalbody mass index and no chronic endocrine disease who were on levetiracetam or valproic acid therapy. Inaddition to routine laboratory tests, fasting insulin level was checked and Homeostatic Model Assessment forinsulin resistance calculated for all patients. Based on these measurements, the effects of levetiracetam andvalproic acid on laboratory parameters were compared statistically.Results: A total of 61 patients (30 males, 31 females) diagnosed with epilepsy were included in the study.Thirty-four (55.7%) the patients were less than 15 years of age and the others were older. Twenty-three (37.7%)patients were on valproic acid therapy and 38 (62.3%) patients were receiving levetiracetam. Thirty-two(52.5%) the patients tested positive for insulin resistance and others were insulin resistance-negative. Nine(28.1%) patients on valproic acid treatment and 71.9% (n = 23) of patients on levetiracetam treatment wereinsulin resistance-positive.Conclusions: In the present study, contrary to the published literature, levetiracetam was found to be associatedwith further negative effects on insulin and blood glucose metabolism compared to valproic acid. Wedetermined that levetiracetam had a distinct pharmacokinetic profile in pediatric patients as demonstrated byits effects on glucose and insulin metabolism.