Valproic Acid and Sodium Valproate

Among many antiepileptic drugs at present, valproic acid is the first choice and broad spectrum drug with wide clinical application, high efficacy and good safety. Valproic acid (debarking?) Not only can it be used to treat all kinds of seizures, especially absence seizures and tonic-clonic seizures, but also can be used for partial seizures. In addition, valproic acid rarely affects cognitive function in patients and rarely causes exacerbation of seizures. The main clinical characteristics of valproic acid are briefly introduced below.

1. Tolerance and withdrawal

Tolerance and drug withdrawal are two important problems in the treatment of epilepsy. Patients may have withdrawal symptoms when they forget to take medicine or need to stop taking medicine; Similarly, once drug resistance is stopped, seizures can be induced. The traditional antiepileptic drug benzodiazepine and Phenobarbital was the most commonly tolerated and withdrawn drug, while valproic acid, phenytoin and carbamazepine were almost nonexistent.

2. Dose adjustment

For doctors and patients, the ideal antiepileptic drug does not need to adjust the dose at the beginning of treatment, or can be adjusted quickly. Phenytoin is the only antiepileptic drug that does not require dose adjustment; Some drugs, such as carbamazepine and tegapine, require a slow dose adjustment; Lamotrigine and topiramate need to be adjusted very slowly; The dosage of valproic acid can be adjusted in a few days to a few weeks.

3. Daily dosage

For patients, treatment compliance is best achieved by taking medication once or twice a day. Valproic acid once a day can well control the onset of idiopathic generalized epilepsy, and 2 times a day can well control the onset of focal epilepsy.

At present, valproic acid sustained release formulations are available for sale, such as Debajin sustained release tablets, which can be taken once a day. The advantage of the sustained-release formulation is that it provides a relatively stable blood concentration and avoids the side effects of high levels of valproic acid in the blood, especially tremors and teratogenic effects. More than 90 percent of prescriptions in France use "extended-release tablets." However, the shortcoming of this tablet is that it is large in size and inconvenient for children to take, so a special slow-release granule has been specially developed for children to solve this problem.

4. Side Effects

Compared with carbamazepine, the side effects of valproic acid were more significant in tremor and weight gain, but less in rash. The acute side effects of valproic acid were mainly gastrointestinal (mostly oral) reactions and tremors. Tremor is a manifestation of mild overdose and can be controlled by reducing the dose.

The chronic toxic effects of valproic acid are varied. The most common is weight gain, and high blood ammonia is also common, but not clinically significant for most patients. Therapeutic doses of valproic acid do not affect cognitive function unless extremely high doses are used.

Although atopic side effects are rare, they are dangerous. The severity of thrombocytopenia is dose-dependent, and surgical studies have shown that thrombocytopenia is not associated with bleeding. The incidence of pancreatitis is about 1 in 40,000; The incidence of hepatitis is about 1/10 000 to 1/40 000. In recent years, with a thorough understanding of the risk factors and intensive surveillance measures, no deaths from pancreatitis or hepatitis have been reported.

Although there are now new anti-epileptic drugs on the market, none are strong enough to challenge valproic acid's position. Valproic acid is still the most commonly used antiepileptic drug in clinical practice today and for some time to come.

Sodium valproate is a broad spectrum antiepileptic drug, that is, the drug is good for any type of epilepsy drugs, can be a single treatment, can also be used as an additive treatment. Generalized epilepsy includes absence seizures, myoclonic seizures, tonic-clonic seizures, atonic seizures, mixed seizures, and even specific types of syndromes. It is also a more common choice for partial seizures. In addition to being a broad-spectrum antiepileptic, it can also be used to treat migraines. As a mood stabilizer, it can be used to treat manic episodes associated with bipolar disorder. Others such as postherpetic neuralgia, tic disorder in children, etc., can also be treated with valproate sodium, sometimes blepharospasm - oral submental dystonia, use of this drug will have symptomatic improvement.

cite:http://www.a-hospital.com/w/%E4%B8%99%E6%88%8A%E9%85%B8