Metabolic and endocrine effects of valproic acid chronic treatment.
Treatment of epileptic patients with valproic acid (VPA) may be associated with substantial weight changes that may increase morbidity and impair adherence to the treatment regimen. VPA-induced weight gain seems to be associated with many metabolic disturbances; the most frequent are hyperinsulinemia and insulin resistance, hyperleptinemia and leptin resistance. Patients who gain weight during VPA therapy can develop dyslipidemia and metabolic syndrome that are associated with long-term vascular complications such as hypertension and atherosclerosis. Moreover, an elevation in the levels of uric acid and homocysteine, together with oxidative stress, may contribute to atherosclerotic risk in patients under long-term therapy with VPA. The aim of this review is to discuss the metabolic and endocrine effects of VPA chronic treatment in patients with epilepsy.
Neurology Unit, Department of Neuroscience, Sant'Anna Hospital, Como, Italy. Electronic address: vincenzobelcastro@libero.it.
Vincenzo
V
Belcastro
Claudia
C
D'Egidio
Pasquale
P
Striano
Alberto
A
Verrotti
D000927:Anticonvulsants / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D006946:Hyperinsulinism / Q000139:chemically induced* / Q000150:complications; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood; D024821:Metabolic Syndrome / Q000097:blood / Q000139:chemically induced*; D014635:Valproic Acid / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D015430:Weight Gain / Q000187:drug effects*
D000927:Anticonvulsants; D020738:Leptin; D014635:Valproic Acid
Atherosclerosis; Epileptic syndromes; Metabolic syndrome; Valproic acid