Valproate effect on ketosis in children under ketogenic diet.

Abstract

INTRODUCTION:

Although ketogenic diet has been proven useful in the management of intractable seizures, interactions with other medicines have been reported. This study reports two patients on co-administration with ketogenic diet and valproate appearing undesirable side effects after increase or decrease of valproate pharmaceutical levels.

METHODS:

Totally 75 patients suffering from drug-resistant epilepsy were treated with ketogenic diet in our departments. Their age varied from 6 months to 9 years. All patients were followed for at least 12 months and up to five years. Clinical and laboratory variables have been regularly assessed.

RESULTS:

In 75 patients treated with ketogenic diet and valproate at the same time treatment was well tolerated. Two patients presented mild to moderate undesirable effects. In these patients the removal of valproate treatment resulted in an increase of ketosis with respective clinical signs. The conversion of the diet from 4:1 to 1:1 and 2,5:1 respectively resulted in reduction of ketosis and clinical improvement.

CONCLUSION:

In the majority of cases co-administration of valproate and ketogenic diet seems to be safe. In two cases, valproate appeared to have a negative effect on ketosis (and weaning it led to over-ketosis). This interaction is worthy of future study.

• Authors: Martha Spilioti, Evangelos Pavlou, Maria Gogou, Irene Katsanika, Efimia Papadopoulou-Alataki, Olga Grafakou, Anastasia Gkampeta, Argyrios Dinopoulos, Athanasios Evangeliou
• Journal: European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society (Eur J Paediatr Neurol) Vol. 20 Issue 4 Pg. 555-9 (Jul 2016) ISSN: 1532-2130 [Electronic] England
• PMID: 27117552 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Anticonvulsants
• Valproic Acid

Topics

• Adolescent
• Anticonvulsants (adverse effects, therapeutic use)
• Child
• Child, Preschool
• Combined Modality Therapy (adverse effects)
• Diet, Ketogenic
• Epilepsy (diet therapy, drug therapy)
• Female
• Humans
• Infant
• Ketosis (chemically induced, diet therapy, drug therapy)
• Male
• Valproic Acid (adverse effects, therapeutic use)