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Efficacy and safety of vitamin E as adjunctive therapy for epilepsy: a systematic review and meta-analysis of randomized control trials.

  • 2025-07-11
  • Frontiers in neurology 16
    • Yanfei Li
    • Gefei He
    • Juanjuan Huang
    • Lin Hu

Study Design

Type
Systematic Review
Sample size
n = 824
Population
11 RCTs involving 824 patients (patients with epilepsy)
Methods
Searched PubMed, Embase, Cochrane Library, and Chinese databases; meta-analysis of RCTs

Objective

Vitamin E, functioning as an antioxidant, holds substantial potential in the adjuvant treatment of epilepsy. However, it remains uncertain whether the existing evidence is adequate to validate the use of vitamin E as an add-on therapy for improving epilepsy outcomes. The aim of this study was to explore the efficacy and safety of vitamin E as an adjuvant treatment for epilepsy.

Methods

We searched PubMed, Embase, the Cochrane Library, and Chinese databases including the Chinese Biomedicine Literature Database, China National Knowledge Infrastructure, Chinese Sci-tech Journal Database, Wanfang Data for eligible studies from inception to February 28, 2025. Meta-analysis was performed to calculate the risk ratio (RR) and weighted mean difference (WMD) of the included randomized controlled trials (RCTs).

Results

Among the 2,348 records obtained, 11 RCTs involving 824 patients were included after literature screening. Vitamin E had a potential advantage in reducing seizure frequency by >75% (RR = 1.73, 95% confidence interval (CI) (1.31, 2.28), p < 0.01), compared with the control group. Subgroup analysis showed a statistically significant difference in the reduction of seizure frequency by >50% (RR = 1.58, 95% CI (1.27, 1.96), p < 0.01) between the vitamin E group and the control group, especially in children (RR = 1.69, 95% CI (1.29, 2.20), p < 0.01). The plasma total antioxidant capacity was higher (WMD = 3.03, 95% CI (2.65, 3.40), p < 0.01) while the malondialdehyde levels were lower (WMD = -6.28, 95% CI (-8.01, -4.54), p < 0.01) in the vitamin E group than in the control group. There was no statistically significant difference in the rates of total adverse events (RR = 0.97, 95% CI (0.93, 1.02), p = 0.25).

Conclusion

Vitamin E shows potential as adjunctive therapy, particularly in pediatric populations, with acceptable safety profile, but high-quality trials are required to confirm its efficacy and safety.

Research Insights

  • Vitamin E→Increased Antioxidant Capacity

    The plasma total antioxidant capacity was higher (WMD = 3.03, 95% CI (2.65, 3.40), p < 0.01)

    Effect
    Beneficial
    Effect size
    Large
  • Vitamin E→No Difference in Adverse Events

    There was no statistically significant difference in the rates of total adverse events (RR = 0.97, 95% CI (0.93, 1.02), p = 0.25)

    Effect
    Neutral
    Effect size
    Small
  • Vitamin E→Reduced Malondialdehyde Level

    the malondialdehyde levels were lower (WMD = -6.28, 95% CI (-8.01, -4.54), p < 0.01) in the vitamin E group than in the control group

    Effect
    Beneficial
    Effect size
    Large
  • Vitamin E→Reduced Seizure Frequency

    Vitamin E had a potential advantage in reducing seizure frequency by >75% (RR = 1.73, 95% confidence interval (CI) (1.31, 2.28), p < 0.01)

    Effect
    Beneficial
    Effect size
    Large
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