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Effective prophylactic therapy for cyclic vomiting syndrome in children using valproate

Toshiyuki Hikita1, Hiroko Kodama, Natsue Nakamoto

  • 1Department of Pediatrics, Teikyo University School of Medicine, Kaga 2-11-1, Itabashi-Ku, Tokyo, Japan. t-hikita@ra2.so-net.ne.jp

Brain & Development
|August 30, 2008
PubMed

Insights

Valproate effectively manages cyclic vomiting syndrome (CVS) in children, reducing attack frequency and severity. This study shows significant improvement in 85% of pediatric patients with severe CVS.

Area of Science:

  • Pediatric Gastroenterology
  • Neurology
  • Pharmacology

Background:

  • Cyclic Vomiting Syndrome (CVS) is a debilitating condition in children, often refractory to standard treatments.
  • Previous therapies including propranolol, amitriptyline, and carbamazepine showed limited efficacy in severe pediatric CVS cases.

Purpose of the Study:

  • To evaluate the efficacy and safety of valproate as a prophylactic treatment for severe cyclic vomiting syndrome in pediatric patients.
  • To assess the response rate and side effects of valproate in children with CVS unresponsive to other medications.

Main Methods:

  • A cohort of 13 children diagnosed with severe CVS received prophylactic valproate (10-40 mg/kg/day).
  • Patients underwent diagnostic tests to exclude organic etiologies prior to treatment.
  • Treatment response was evaluated based on symptom resolution, frequency, and severity of vomiting episodes.

Main Results:

  • 85% of patients (11 out of 13) experienced significant improvement, with 2 showing complete resolution and 9 exhibiting marked symptom reduction.
  • Two patients did not respond to valproate therapy.
  • No significant side effects were observed during long-term valproate administration.

Conclusions:

  • Valproate demonstrates considerable efficacy and a favorable safety profile for the prophylactic management of severe cyclic vomiting syndrome in children.
  • Valproate represents a promising therapeutic option for pediatric CVS patients, particularly those with treatment-resistant symptoms.

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