Long-term safety, tolerability, and efficacy of magnesium valproate versus sodium valproate in acute seizures

Abstract

Objectives: To evaluate the safety, tolerability and efficacy of magnesium valproate and sodium valproate as monotherapies in patients with epilepsy in China.

Methods: We recruited patients admitted with seizures over a two-year period. All patients underwent early neurological assessments, electroencephalogram testing, and neuroimaging. The treatments received at baseline and at one year of follow-up were compared.

Results: In total, 175 patients were included. The retention rates of the magnesium valproate and sodium valproate treatments were 73.1% and 64.2%, respectively. The main cause of discontinuation was the development of intolerable adverse events. The retention rate and total effective rate in the magnesium valproate group were significantly higher than those in the sodium valproate group (73.1% and 70.2% versus 64.2% and 47.2%, respectively). The safety endpoints included 120 patients (magnesium valproate: n = 67; sodium valproate: n = 53). The incidence of adverse events in the magnesium valproate group was significantly lower than that in the sodium valproate group (30% versus 51%).

Conclusions: Magnesium valproate treatment shows favorable safety and tolerability and is associated with markedly improved seizure control. Ideally, future large, prospective, randomized, and double-blind studies are needed to confirm these findings.

Keywords:

• Epilepsy
• antiepileptic drugs
• drug retention
• tolerability

Transparency

Declaration of funding

This work was supported by the National Natural Science Foundation of China [grant numbers is 81701279] and the Chongqing Natural Science Foundation Project [cstc2019jcyj-msxmX0184].

Declaration of financial/other relationships

The authors have no relationships to declare. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Conception and design of the study: XX, XYP; analysis and interpretation of the data: XYP, RC, YY; drafting of the paper: XX; critical revision of the paper for intellectual content: XFW, YY.

Acknowledgements

We are sincerely grateful for the support of Chongqing, Zhengzhou and Guangzhou epilepsy research centers of comprehensive hospitals for supplying patients. In addition, we would like to thank all the patients and their families for their participation in this study.