Valproate not effective in partial seizures--error in First Aid?

[Ruban]

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I'm looking at the table of antiepileptics in FA 2005 p. 302. It shows that valproic acid is not effective for partial seizures, but only for absence and tonic-clonic seizures. Is this accurate? My other source suggest valproic acid is useful in partial seizures as well, and my Katzung even suggests it is a 1st line agent in partial seizures.

 

[Bounty]

I'm looking at the table of antiepileptics in FA 2005 p. 302. It shows that valproic acid is not effective for partial seizures, but only for absence and tonic-clonic seizures. Is this accurate? My other source suggest valproic acid is useful in partial seizures as well, and my Katzung even suggests it is a 1st line agent in partial seizures.

I dont know what they want for the boards, but our school lecture on seizures definitely listed valproate as useful for partial as well.

 

[pujllay]

I'm looking at the table of antiepileptics in FA 2005 p. 302. It shows that valproic acid is not effective for partial seizures, but only for absence and tonic-clonic seizures. Is this accurate? My other source suggest valproic acid is useful in partial seizures as well, and my Katzung even suggests it is a 1st line agent in partial seizures.

The 2003 FA Epilepsy Drugs also shows the same (page 321).

The Sept. 2004 British National Formulary states Na Valproate has shown similar efficacy as phenytoin and carbamazepine in partial epilepsy. The sixth edition Oxford handbook does not longer considered phenytoin as 1st line for generalized and partial epilepsy due ot its toxicities (nystagmus, dyplopia, etc) thus giving preference to carbamazepine and Na valproate. I actually checked this with my cardiology consultant - who is drug guru - two weeks ago and his answer was: every drugs has side effects and you should work with the one you're familiar.

I think FA has not yet updated its table = not accurate! Good question about what the boards expects us to know????

 

[Doc Ivy]

yup. I just finishing reading the antileptic chapter in Katzung and it says that valproic acid is good for pretty much all seizure types-- so maybe FA is just giving us the "first line" approach to partial seizure

 

[Ruban]

yup. I just finishing reading the antileptic chapter in Katzung and it says that valproic acid is good for pretty much all seizure types-- so maybe FA is just giving us the "first line" approach to partial seizure

But Katzung suggests that valproate is first-line for partial seizures. Moreover, if FA was giving first-line drugs, why would they checkmark drugs like lamotrigine and gabapentin?