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[Advantages of a single daily dose of sodium valproate in the child]
M Giroud1, G Couillault, J B Gouyon
1Laboratoire d'Explorations Neurophysiologiques, Hôpital d'Enfants, Dijon.
Insights
A single daily dose of sodium valproate (SV) effectively treats epilepsy in children, showing comparable efficacy to multiple doses with no observed side effects. This simplified regimen offers a promising alternative for managing pediatric epilepsy.
Area of Science:
- Neurology
- Pharmacology
Context:
- Epilepsy management in children requires effective and safe treatment options.
- Current treatments often involve multiple daily doses, impacting adherence.
- Idiopathic generalized epilepsy is a common form in pediatric populations.
Purpose:
- To evaluate the efficacy and safety of a single daily dose of sodium valproate (SV) compared to three daily doses in children with epilepsy.
- To assess clinical outcomes, side effects, and serum SV levels with a simplified dosing regimen.
Summary:
- Thirty-five children (5-15 years) with idiopathic generalized epilepsy were studied.
- After one year on three daily doses, patients transitioned to a single 8 PM dose.
- Efficacy and safety were monitored for one year, with clinical exams and lab tests every three months.
Impact:
- A single daily dose of SV demonstrated significant efficacy, with many patients remaining seizure-free.
- The simplified regimen was well-tolerated, showing no adverse side effects.
- Results suggest a potential for improved treatment adherence and comparable therapeutic outcomes with once-daily SV dosing.
Abstract:
This study was aimed at testing the efficacy and innocuousness of a single dose of sodium valproate (SV) for the treatment of epilepsy, as compared with 3 daily doses. It was tested on 35 children, 5 to 15 years of age, presenting with the idiopathic form of generalized epilepsy. At the end of one year of treatment with 20 mg/kg/day of SV in 3 daily doses, the children were given a single dose at 8 PM daily. Every 3 months for a period of one year, patients were examined in order to monitor the clinical efficacy and side effects, liver function tests and serum levels of SV at 9 AM and 6 PM. Twenty patients who were well controlled with 3 daily doses had no fits with the single dose treatment. Ten patients, who had had one fit every 6 months during the observation year had no convulsions during the year on a single dose: however, 5 others who had had one fit every 6 months with 3 doses, had fits with the same frequency with the single dose treatment. There were no side effects. SV plasma levels at 9 AM were always higher than those at 6 PM. The efficacy of a single dose may result from the action of SV which increases the intra-cerebral levels of GABA, which are delayed and prolonged.