{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T02:04:27Z","timestamp":1773453867301,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T00:00:00Z","timestamp":1683590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009471","name":"EkstraStiftelsen Helse og Rehabilitering","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009471","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the potential influence of a ketogenic diet on serum concentrations of antiseizure medications (ASMs) in children with drug resistant epilepsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We investigated the serum concentrations of ASMs in 25 children with drug resistant epilepsy, 2\u201313\u2009years of age, treated with a classical ketogenic diet for 12\u2009weeks. The patients were recruited from the National Centre for Epilepsy from August 15th, 2017, to January 24th, 2022. Changes in ASM serum concentrations were analyzed using a mixed effect model analysis. Significance level was set at <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05 for all comparisons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The participants used 12 different ASMs during the study. The mean number of ASMs was 2.4 (\u00b1SD 0.7). None of the participants changed the type or dose of the ASMs during the intervention period. The serum concentrations of clobazam (<jats:italic>n<\/jats:italic>\u2009=\u20099, <jats:italic>P<\/jats:italic>\u2009=\u20090.002), desmethylclobazam (<jats:italic>n<\/jats:italic>\u2009=\u20099, <jats:italic>P<\/jats:italic>\u2009=\u20090.010), and lamotrigine (<jats:italic>n<\/jats:italic>\u2009=\u20096, <jats:italic>P<\/jats:italic>\u2009=\u20090.016) decreased significantly during the dietary treatment. The analytes with the largest reduction in serum concentration after 12\u2009weeks of dietary treatment were clobazam (mean change \u221238%) and desmethylclobazam (mean change \u221237%). We found no significant change in the serum concentrations of levetiracetam, topiramate, and valproic acid.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>We identified a significant decrease in the serum concentrations of clobazam, desmethylclobazam, and lamotrigine following a 12\u2010week ketogenic diet intervention in children with drug resistant epilepsy. An unintended decrease in the serum concentrations of ASMs may render the patient prone to seizures. Measurements of ASM serum concentrations might be useful in patients on a ketogenic diet, especially in patients with lack of efficacy of the dietary treatment.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.12746","type":"journal-article","created":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T13:13:56Z","timestamp":1681478036000},"page":"858-866","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Decreased serum concentrations of antiseizure medications in children with drug resistant epilepsy following treatment with ketogenic diet"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4035-3073","authenticated-orcid":false,"given":"Sigrid","family":"Pedersen","sequence":"first","affiliation":[{"name":"National Centre for Epilepsy, Member of the ERN EpiCare Oslo University Hospital  Oslo Norway"},{"name":"Institute of Clinical Medicine University of Oslo  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1778-0835","authenticated-orcid":false,"given":"Magnhild","family":"Kverneland","sequence":"additional","affiliation":[{"name":"National Centre for Epilepsy, Member of the ERN EpiCare Oslo University Hospital  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Knut","family":"Rudi","sequence":"additional","affiliation":[{"name":"Department of Chemistry Norwegian University of Life Sciences  \u00c5s Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Gervin","sequence":"additional","affiliation":[{"name":"Department of Research and Innovation Oslo University Hospital  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0877-8912","authenticated-orcid":false,"given":"Cecilie Johannessen","family":"Landmark","sequence":"additional","affiliation":[{"name":"National Centre for Epilepsy, Member of the ERN EpiCare Oslo University Hospital  Oslo Norway"},{"name":"Department of Pharmacology Oslo University Hospital  Oslo Norway"},{"name":"Department of Pharmacy Oslo Metropolitan University  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Per Ole","family":"Iversen","sequence":"additional","affiliation":[{"name":"Department of Nutrition University of Oslo  Oslo Norway"},{"name":"Department of Hematology Oslo University Hospital  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaja Kristine","family":"Selmer","sequence":"additional","affiliation":[{"name":"National Centre for Epilepsy, Member of the ERN EpiCare Oslo University Hospital  Oslo Norway"},{"name":"Department of Research and Innovation Oslo University Hospital  Oslo Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,5,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2009.02481.x"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200002033420503"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.3949"},{"key":"e_1_2_12_5_1","first-page":"308","article-title":"The effect of ketonemia on the course of epilepsy","volume":"2","author":"Wilder R","year":"1921","journal-title":"Mayo Clin Proc"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.16364"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.12578"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2005.11.001"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.2010.01359.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/17425255.2020.1724956"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.13709"},{"key":"e_1_2_12_12_1","unstructured":"Norwegian Food Safety Authority TNDoH University of Oslo. 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