2001 suplement 1

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Volume 10, suplement 1

Review article

The role of valproic acid and its salts in the treatment of epilepsy

Danuta Rościszewska1
1. II Katedry i Kliniki Neurologii Śląskiej AM w Zabrzu
Postępy Psychiatrii i Neurologii, 2001, 10 suplement 1 (13), 11-18
Keywords: valproic acid, clinical efficacy, side effects, literature review

Abstract

An attempt was made to overview the knowledge about the valproic acid and sodium valproate (Depakine) clinical application, with the emphasis on practical aspects. Valproic acid is regarded as a first-line drug in the treatment of epilepsy. It is very effective in cases of primary generalized epilepsy (with myoclonic and tonic-clonic seizures, as well as absences). Sodium valproate is a drug of choice in juvenile myoclonic epilepsy. Recent studies indicate the drug efficacy in the treatment of complex partial seizures, both as monotherapy and adjunctive therapy. Efficacy of valproic acid is comparable to that of ethosuximide in the treatment of absence seizures, and to carbamazepine and phenytoin – in the treatment of both tonic-clonic and partial seizures. Valproic acid monotherapy does not require drug concentration monitoring in all patients. The most frequent dose-related side effect is tremor. Other side effects include weight gain and hair loss. Idiosyncratic reactions are rare. As in the case of other antiepileptic drugs, there is a risk of teratogenesis, therefore a very careful assessment during pregnancy is necessary. Research findings indicate that VPA intravenous administration is highly effective in status epilepticus. Conclusions: Valproic acid and its salts present a broad spectrum of anticonvulsant activity, do not induce other types of seizures, and do not disturb cognitive functions. In practice, the choice among first-line drugs may be based on their different side effect profiles.

Address for correspondence:
Joanna Jędrzejczak,
Klinika Neurologii i Epileptologii CMKP,
ul. Czerniakowska 231,
00-416 Warszawa