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Related Experiment Videos

Changes in red blood cells with valproate therapy

C Ozkara1, F E Dreifuss, C Apperson Hansen

  • 1Comprehensive Epilepsy Program, University of Virginia, Charlottesville 22908.

Acta Neurologica Scandinavica
|September 1, 1993
PubMed
Summary

Valproate medication can increase red blood cell volume (MCV) and hemoglobin content (MCH) in epilepsy patients. This study found Valproate significantly raises MCV, but it does not cause anemia.

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Area of Science:

  • Neurology
  • Hematology
  • Pharmacology

Background:

  • Valproate is a widely used antiepileptic drug (AED).
  • Elevated red blood cell indices (MCV, MCH) have been observed in patients on Valproate therapy.
  • The clinical significance of these changes requires further investigation.

Purpose of the Study:

  • To investigate the effect of Valproate on red blood cell indices.
  • To compare Valproate's effects with other antiepileptic drugs like carbamazepine and phenytoin.
  • To determine if Valproate-induced changes are associated with anemia.

Main Methods:

  • Studied 41 epileptic patients on Valproate monotherapy (Group 1).
  • Evaluated 20 patients on Valproate plus another AED (Group 4).
  • Compared with 19 patients on carbamazepine (Group 2) and 12 on phenytoin (Group 3).

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  • Monitored red blood cell mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) values.
  • Performed peripheral blood smears and reticulocyte counts to rule out anemia.

    • Main Results:

    • Significant increases in MCV were observed in patients on Valproate (Groups 1 and 4).
    • No significant changes in MCH were reported.
    • Peripheral blood smear and reticulocyte counts ruled out macrocytic anemias.
    • Carbamazepine and phenytoin groups did not show significant MCV increases.

    Conclusions:

    • Valproate therapy is associated with a significant increase in MCV.
    • This effect appears to be independent of macrocytic anemia.
    • A generalized alteration in erythrocyte membrane phospholipids is postulated as the underlying mechanism.