The Effects of Oxcarbazepine and Valproate Therapies on Growth in Children with Epilepsy

Abstract

Aim. This study aimed to evaluate the effects of monotherapy with valproate or oxcarbazepine on the linear growth of children with idiopathic epilepsy. Methods. Antiepileptic treatment with valproate or oxcarbazepine was initiated in 76 patients. These were evaluated at baseline and at 6 and 18 months after commencement of therapy to determine height standard deviations (height z-scores). Serum ghrelin, insulin-like growth factor-1, and insulin-like growth factor-binding protein-3 levels were measured. Results. In prepubertal patients receiving oxcarbazepine, height z-scores were elevated after 6 and 18 months of therapy (p = 0.008 and p = 0.001, respectively); in pubertal patients, a significant increase was noted at the 18th month of therapy (p = 0.004). In prepubertal patients receiving oxcarbazepine, serum standardized insulin-like growth factor-1 and insulin-like growth factor-binding protein-3 levels were significantly higher at the 18th month of therapy compared with baseline (p = 0.005 and p = 0.004, respectively). In puber-tal patients receiving valproate, serum ghrelin levels were significantly decreased at the 18th month of therapy compared with baseline (p = 0.006). Conclusion. Exposure to oxcarbazepine stimulated linear growth in epileptic patients through mechanisms involving the release of insulin-like growth factor-1 and insulin-like growth factor-binding protein-3. In contrast, expo-sure to valproate did not affect linear growth, but did lead to a decrease in serum ghrelin levels.

• Antiepileptic drugs
• Growth
• Weight
• Insulin-like growth factor-1
• Ghrelin
• Epilepsy

ACKNOWLEDGMENTS

This study was conducted at the Gazi University, Department of Pediatric Neurology, Turkey. We would like to thank Elif Ayvali, from the Pediatric Endocrinology Laboratory, Faculty of Medicine, Gazi University, Ankara, for her valuable contributions. This study was funded by Çocuk ve Ergen Obezite Derneği, a local association, one of whose aims is to support studies on endocrine functions in children.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.