PMID: 9558128Apr 29, 1998Paper

Valproate as monotherapy for juvenile myoclonic epilepsy: dose-effect study

Therapeutic Drug Monitoring
A SundqvistB Lundkvist

Abstract

Sodium valproate enteric-coated tablets were used in this double-blind, randomized, cross-over study of 16 patients with juvenile myoclonic epilepsy comparing 1000 mg and 2000 mg VPA daily in b.i.d. administration with 6 months of observation on each dose. Myoclonic, absence, and generalized tonic-clonic seizures were registered separately. Subjective side-effects were monitored, and a computerized neuropsychologic test battery was performed on each dose. There was no significant difference in seizure frequency between the two doses. Only 25% of the patients were seizure free throughout the study despite concentrations well within the normally proposed therapeutic range for VPA. During the higher dose, 37.5% of the patients had an improved seizure control, but 25% of the patients had an increase in seizure frequency compared to the lower dose. However, there was no correlation between VPA concentrations and subjective side-effects or neuropsychologic test results. Our observations point out the possibility that the common strategy of increasing plasma levels in difficult-to-treat patients until side effects occur should perhaps be reconsidered, but this suggestion needs further confirmation.

References

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Apr 1, 1997·Therapeutic Drug Monitoring·A SundqvistB Lundkvist

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Citations

Dec 15, 2012·Expert Review of Neurotherapeutics·Pasquale Striano, Vincenzo Belcastro
May 15, 2013·Expert Opinion on Pharmacotherapy·Pasquale Striano, Vincenzo Belcastro
Oct 27, 2009·Neurologic Clinics·Linda J Stephen, Martin J Brodie
Sep 27, 2003·Acta Neurologica Scandinavica. Supplementum·E Ben-MenachemS Stodieck
Aug 13, 2015·Epilepsy & Behavior : E&B·Ivan RektorAmos D Korczyn
Feb 28, 2015·Practical Neurology·Naveed MalekJohn Greene
Jun 14, 2013·Epilepsy & Behavior : E&B·Arielle CrespelPierre Genton
Jun 15, 2016·Epilepsy & Behavior : E&B·Laura E Hernández-VanegasIris E Martínez-Juárez
Jul 19, 2016·Clinical Neuropharmacology·Rachel G GreenbergJeffrey T Guptill
Apr 16, 2002·Journal of Child Neurology·Raj D Sheth

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