[P2-124] Experience of Valproic Acid Shifting to Levetiracetam in Childbearing Age Women With Epilepsy
[Introduction]:
The purpose is to describe our experience in valproic acid switched to levetiracetam in childbearing age women with epilepsy. Valproic acid, the common first-line agent for many generalized epilepsy syndrome, especially juvenile myoclonic epilepsy, has chronic adverse effects, including irregular menstrual cycle, weight gain, and teratogenic effect. The teratogenic and other adverse effects are dose dependent. Switching valproaic acid to levetiracetam may benefit in decreasing the adverse effects.
[Methodology]:
We reviewed the medical records of childbearing age female patients with epilepsy who were treated with valproic acid initially and then switched to levetiracetam in Chang Gung Memorial Hospital from 2002 to 2016.The demographic data, results of EEG and imaging studies, antiepileptic drugs history, valproic acid initial dosage and final dosage, adverse effects related and therapeutic response to treatment were recorded. Successful switching was defined as decreased daily valproic acid dosage.
[Results]:
Total 11 female patients were enrolled (median age 24-year-old). There were 7 (63.6%) successful cases out of 11. Two of them had decreased dosage of valproic acid, four with levetiracetam monotherapy at the last clinic visit (4/7), and one with levetiracetam discontinuation. There were 4 (36.4%) unsuccessful cases. Two of them needed to increase valproic acid dosage to achieve seizure controlled after levetiracetam add-on. There were improvements in metrorrhagia and alopecia in 4 of 5 successful cases (4/5) after tapered dosage of valproic acid.
[Conclusions]:
Our experience supports switching valproic acid to levetiracetam in child-bearing women with epilepsy as an alternative treatment to reduce adverse effects.
The purpose is to describe our experience in valproic acid switched to levetiracetam in childbearing age women with epilepsy. Valproic acid, the common first-line agent for many generalized epilepsy syndrome, especially juvenile myoclonic epilepsy, has chronic adverse effects, including irregular menstrual cycle, weight gain, and teratogenic effect. The teratogenic and other adverse effects are dose dependent. Switching valproaic acid to levetiracetam may benefit in decreasing the adverse effects.
[Methodology]:
We reviewed the medical records of childbearing age female patients with epilepsy who were treated with valproic acid initially and then switched to levetiracetam in Chang Gung Memorial Hospital from 2002 to 2016.The demographic data, results of EEG and imaging studies, antiepileptic drugs history, valproic acid initial dosage and final dosage, adverse effects related and therapeutic response to treatment were recorded. Successful switching was defined as decreased daily valproic acid dosage.
[Results]:
Total 11 female patients were enrolled (median age 24-year-old). There were 7 (63.6%) successful cases out of 11. Two of them had decreased dosage of valproic acid, four with levetiracetam monotherapy at the last clinic visit (4/7), and one with levetiracetam discontinuation. There were 4 (36.4%) unsuccessful cases. Two of them needed to increase valproic acid dosage to achieve seizure controlled after levetiracetam add-on. There were improvements in metrorrhagia and alopecia in 4 of 5 successful cases (4/5) after tapered dosage of valproic acid.
[Conclusions]:
Our experience supports switching valproic acid to levetiracetam in child-bearing women with epilepsy as an alternative treatment to reduce adverse effects.