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Moving beyond sodium valproate: choosing the right anti-epileptic drug in children

Ganna Balagura1,2, Giulia Iapadre3, Alberto Verrotti3

  • 1Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Opthalmology, Genetics, Maternal and Child's Health, University of Genoa , Genoa , Italy.

Expert Opinion on Pharmacotherapy
|May 18, 2019
PubMed

Insights

Sodium valproate, a common anti-epileptic drug for children, carries risks like teratogenicity. Reassessing its use and exploring alternatives is crucial for safer epilepsy treatment in pediatric patients.

Area of Science:

  • Pediatric Neurology
  • Pharmacology
  • Epilepsy Treatment

Background:

  • Sodium valproate has been a first-line anti-epileptic drug for children for 50 years due to its broad efficacy.
  • Significant adverse effects, including teratogenicity and neuro-cognitive impairments, necessitate a reevaluation of its use.

Purpose of the Study:

  • To review the adverse effects and drug interactions associated with sodium valproate in pediatric epilepsy.
  • To examine current alternatives to sodium valproate for various seizure types in children and adolescents.
  • To discuss future directions for individualized epilepsy therapy in pediatric populations.

Main Methods:

  • Literature review of sodium valproate's adverse effects and drug interactions.
  • Review of current alternative anti-epileptic drugs for pediatric seizure types (absence, myoclonic, tonic-clonic, focal onset).
  • Analysis of research needs and future perspectives in pediatric epilepsy management.

Main Results:

  • Sodium valproate presents significant risks, including teratogenicity and neuro-cognitive issues in offspring.
  • Several alternative anti-epileptic drugs are available for different seizure types in children and adolescents.
  • There is a need for further research addressing the unique aspects of pediatric epilepsy treatment.

Conclusions:

  • The established role of sodium valproate in pediatric epilepsy requires reassessment due to its adverse effect profile.
  • Individualized treatment approaches and exploration of newer or targeted older anti-epileptic drugs are essential.
  • Future epilepsy therapy in children should prioritize personalized strategies to optimize efficacy and minimize harm.

Keywords:
Epilepsyadverse effectsantiseizure drugschildrentherapyvalproate

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