Hematological Side Effects of Valproate Used for the Treatment of Epilepsy

• Published in: Namık Kemal tıp dergisi Vol. 9; no. 1; pp. 39 - 42
• Main Authors: YILMAZBAŞ, Pınar, ŞENBİL, Nesrin
• Format: Journal Article
• Language: English
• Published: Galenos Yayınevi 01.04.2021; Galenos Yayincilik
• Subjects: anemia; epilepsy; thrombocytopenia; Tıp; valproate; Tekirdağ; Türkiye; epilepsy; epilepsi; Valproat; thrombocytopenia; trombositopeni; anemia; anemi; Valproate
• ISSN: 2587-0262; 2587-0262
• DOI: 10.4274/nkmj.galenos.2020.800497

Aim: Valproate is a commonly used antiepileptic drug with hematologic and non-hematologic side effects at therapeutic doses. The aim of this study was to investigate the relationship between the known hematological side effects of valproate and duration, dose and serum levels of this drug. Materials and Methods: The study population consisted of patients with epilepsy followed by pediatric neurology outpatient clinic, who had been using valproate for at least 3 months. Duration of treatment, valproate doses, hemogram and serum valproate levels of patients were recorded from their files. Patients with other systemic and/or hematological diseases and those who were taking drugs other than valproate were not included in the study. Results: Serum valproate levels and complete blood count results were obtained in 80 of 112 patients who met the criteria. Thirty of them (37.5%) were female. The mean age was 8.2±4.8 years (1-16 years) and the mean duration of treatment was 19.93±16.4 months (3 months-10 years). Valproate use dose ranged from 20 to 60 mg/kg day. At least one hematologic side effect was detected in 34 (42%) patients. These side effects were macrocytosis (18.7%), thrombocytopenia (17.5%), leukopenia (12.5%) and anemia (7.5%). There was no correlation between thrombocytopenia and valproate using time, but a significant correlation was found between dose and serum levels. There was a relationship between macrocytosis and serum valproate level only. No correlation was found between leukopenia and anemia and duration of treatment, dose and serum levels. Conclusion: Hematological side effects of valproate used in the treatment of epilepsy are not uncommon, and these side effects are unpredictable. Therefore, it was concluded that complete blood counts should be sufficient in the follow-up of the patients and families should be informed about the side effects.