Use of valproates in women of childbearing age and pregnant women with epilepsy

Nevrologiâ, Nejropsihiatriâ, Psihosomatika

P. N. Vlasov¹ 

[1] Department of Nervous System Diseases, Faculty of Therapeutics, A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow, Russia20, Delegatskaya St., Build. 1, Moscow 127473;

关键词: valproate;    valproic acid;    childbearing-aged women;    epilepsy;    pregnancy;   

DOI  :  10.14412/2074-2711-2015-1S-4-9

来源: DOAJ

【 摘 要 】

The paper considers the specificity of using valproic acid (VA) preparations in young childbearing-aged women with epilepsy and discusses the clinical situations of practical application of valproates during pregnancy in view of the baseline efficiency of therapy, the type of epileptic seizures, and the form of epilepsy. It provides a few scenarios of the course of pregnancy and possible treatment policy. Owing to its multiple mechanism of action, VA has been effectively used to treat idiopathic (generalized/focal) cryptogenic and symptomatic focal epilepsies in patients of different age groups, including in childbearing-aged women. It is also effectively used to treat manias in the pattern of bipolar disorders and to prevent migraine. The range of action (the efficiency against different types of seizures and forms of epilepsy), good tolerance, a minimal aggravation risk, high continuous therapy rates, various drug dosage forms, including long-acting or intravenous formulatons, and favorable pharmacokinetic and pharmacodynamics profiles make VA indispensable at the present developmental stage of epileptology. However, VA has definite limitations: the drug is contra-indicated in some forms of mitochondrial encephalopathies; its prescription to young women requires comprehensive assessment of possible therapy consequences, especially in pregnancy planning, the drug should be used with extreme caution in the first trimester of pregnancy. The ideal variant of VA prescription in young women of fertile age is monotherapy, by using its minimal effective daily dose and sustained-release formulations.

【 授权许可】

Unknown