Adjunctive Nutritional Supplementation in Drug-Resistant Epilepsy: A Prospective Observational Study Evaluating Quality of Life and Seizure Outcomes

Introduction: Drug-resistant or refractory epilepsy remains a significant clinical challenge, with persistent seizures and impaired quality of life, despite optimized antiepileptic therapy. Increasing attention has been directed toward adjunctive nutritional strategies that may support neuronal stability and overall well-being. The aim of the present study was to evaluate the real-world impact of Epregres Unique 12 as an adjunct to standard antiepileptic drug therapy on the quality of life and seizure frequency in patients with drug-resistant epilepsy. Materials and methods: This prospective observational study was conducted at a tertiary care center between January 2023 and December 2024. Twenty-six patients with drug-resistant epilepsy were followed for 12 weeks after the initiation of adjunctive nutritional supplementation. Antiepileptic drug regimens were continued without protocol-driven modifications. The quality of life was assessed using the Quality of Life in Epilepsy-31 (QOLIE-31) questionnaire at baseline and after 12 weeks. Seizure frequency was documented by using patient-maintained seizure diaries. Data were analyzed using paired statistical tests with effect size estimation. Results: Twenty-six patients (19 males, seven females; mean age 37.2 ± 7.4 years) were included. Emotional well-being showed a statistically significant improvement at 12 weeks (p = 0.009) with a moderate effect size. The total QOLIE-31 score demonstrated a clinically meaningful improvement, approaching statistical significance (p = 0.061). Seizure frequency decreased in 20 (76.9%) patients, including complete seizure cessation in 6 (23.1%) patients. The supplement was well-tolerated, with only one minor adverse event reported. Conclusion: Adjunctive nutritional supplementation is associated with improvements in emotional well-being and favorable trends in quality of life and seizure frequency in patients with drug-resistant epilepsy. While these findings are encouraging, controlled studies with larger sample sizes are required to confirm these observations.