Commentary on clinical significance of CYP2C9-status-guided valproic acid therapy in children

Epilepsia ◽  
2016 ◽  
Vol 57 (8) ◽  
pp. 1338-1339 ◽  
Author(s):  
Rolf C. W. Gielgens ◽  
Levinus A. Bok
Keyword(s):  
Valproic Acid ◽  
Clinical Significance ◽  
Acid Therapy ◽  
Valproic Acid Therapy

scholarly journals In response: Commentary on clinical significance of CYP2C9-status-guided valproic acid therapy in children

Epilepsia ◽  
2016 ◽  
Vol 57 (8) ◽  
pp. 1339-1340 ◽  
Author(s):  
Katalin Monostory ◽  
Tamás Bűdi ◽  
Katalin Tóth ◽  
Andrea Nagy ◽  
Zsuzsa Szever ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Clinical Significance ◽  
Acid Therapy ◽  
Valproic Acid Therapy

scholarly journals Clinical significance of CYP2C9-status guided valproic acid therapy in children

Epilepsia ◽  
2015 ◽  
Vol 56 (6) ◽  
pp. 849-855 ◽  
Author(s):  
Tamás Bűdi ◽  
Katalin Tóth ◽  
Andrea Nagy ◽  
Zsuzsa Szever ◽  
Ádám Kiss ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Clinical Significance ◽  
Acid Therapy ◽  
Valproic Acid Therapy

Association of genetic variants in six candidate genes with valproic acid therapy optimization

2011 ◽  
Vol 12 (8) ◽  
pp. 1107-1117 ◽  
Author(s):  
Chin-Chuan Hung ◽  
Jia-Ling Ho ◽  
Wei-Lun Chang ◽  
John Jen Tai ◽  
Tsung-Jen Hsieh ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Candidate Genes ◽  
Genetic Variants ◽  
Acid Therapy ◽  
Valproic Acid Therapy

Effect of Valproic Acid Therapy on Zinc Metabolism in Children with Primary Epilepsy

1987 ◽  
Vol 10 (1) ◽  
pp. 80-86 ◽  
Author(s):  
T. Lerman-Sagie ◽  
M. Statter ◽  
G. Szabo ◽  
P. Lerman
Keyword(s):  
Valproic Acid ◽  
Zinc Metabolism ◽  
Acid Therapy ◽  
Valproic Acid Therapy

The Role of Carnitine Supplementation during Valproic Acid Therapy

2000 ◽  
Vol 34 (5) ◽  
pp. 630-638 ◽  
Author(s):  
Jackie Y Raskind ◽  
Gladys M El-Chaar
Keyword(s):  
Valproic Acid ◽  
Advisory Committee ◽  
Randomized Clinical Trials ◽  
Pediatric Population ◽  
Carnitine Deficiency ◽  
Carnitine Supplementation ◽  
Acid Therapy ◽  
Pediatric Neurology ◽  
Valproic Acid Therapy

OBJECTIVE: To review the pathophysiology and significance of valproic acid–induced carnitine deficiency; to present and evaluate the literature pertaining to carnitine supplementation in pediatric patients receiving valproic acid; and to present the consensus guidelines for carnitine supplementation during valproic acid therapy. DATA SOURCES: A MEDLINE search (1966–December 1998) restricted to English-language literature, using MeSH headings of carnitine and valproic acid, was conducted to identify clinically relevant articles. Selected articles and references focusing on the pediatric population were included for review. DATA EXTRACTION: Study design, patient population, methods, and clinical outcomes were evaluated. DATA SYNTHESIS: Valproic acid, a widely used antiepileptic agent in the pediatric population, is limited by a 1/800 incidence of fatal hepatotoxicity in children under the age of two years. Carnitine is an essential amino acid necessary in β-oxidation of fatty acids and energy production in cellular mitochondria. It has been hypothesized that valproic acid may induce a carnitine deficiency in children and cause nonspecific symptoms of deficiency, hepatotoxicity, and hyperammonemia. Relevant published case reports and trials studying this relationship are evaluated, and a consensus statement by the Pediatric Neurology Advisory Committee is reviewed. CONCLUSIONS: Despite the lack of prospective, randomized clinical trials documenting efficacy of carnitine supplementation in preventing valproic acid–induced hepatotoxicity, the few limited studies available have shown carnitine supplementation to result in subjective and objective improvements along with increases in carnitine serum concentrations in patients receiving valproic acid. The Pediatric Neurology Advisory Committee in 1996 provided more concrete indications on the role of carnitine in valproic acid therapy, such as valproic acid overdose and valproic acid–induced hepatotoxicity. Carnitine was strongly recommended for children at risk of developing a carnitine deficiency. Although carnitine has been well tolerated, future studies are needed to evaluate the efficacy of prophylactic carnitine supplementation for the prevention of hepatotoxicity.

Pancreatitis Associated with Valproic Acid Therapy

PEDIATRICS ◽  
1979 ◽  
Vol 64 (4) ◽  
pp. 521-521
Author(s):  
Paul B. Batalden ◽  
Bruce J. Van Dyne ◽  
James Cloyd
Keyword(s):  
Valproic Acid ◽  
Acid Therapy ◽  
Valproic Acid Therapy

Since submission of this manuscript, two additional cases of pancreatitis associated with valproic acid therapy have been reported.18

Valproic acid therapy in childhood epilepsy

JAMA ◽  
1980 ◽  
Vol 244 (8) ◽  
pp. 785-788 ◽  
Author(s):  
D. L. Coulter
Keyword(s):  
Valproic Acid ◽  
Childhood Epilepsy ◽  
Acid Therapy ◽  
Valproic Acid Therapy

Carnitine deficiency and hyperammonemia associated with valproic acid therapy

1982 ◽  
Vol 101 (5) ◽  
pp. 782-785 ◽  
Author(s):  
Yoshinobu Ohtani ◽  
Fumio Endo ◽  
Ichiro Matsuda
Keyword(s):  
Valproic Acid ◽  
Carnitine Deficiency ◽  
Acid Therapy ◽  
Valproic Acid Therapy
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