Expanded therapeutic range of valproate.
Twenty-five pediatric patients with serum valproate levels above 100 micrograms/ml (therapeutic range: 50-100 micrograms/ml) are reviewed for nondose-related side effects and seizure control. The dose of valproate varied from 50-100 mg/kg/day. All patients had generalized or mixed seizure disorders which were difficult to control. Seizure frequency decreased by more than 50% in 14 patients. For those patients with improved control, valproate levels ranged from 111-196 micrograms/ml. Patients were carefully monitored for side effects; nondose-related side effects were not encountered. Random valproate levels were between 100-200 micrograms/ml. The clinical response to valproate can be augmented by increasing it to the maximum tolerated dose.
Hurst
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Child Neurology Clinic, Fitzsimons Army Medical Center, Aurora, Colorado.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy*; D005071:Evoked Potentials / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D014635:Valproic Acid / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics
D014635:Valproic Acid