Valproic acid-induced hepatopathy: nine new fatalities in Germany from 1994 to 2003

Epilepsia. 2006 Dec;47(12):2027-31. doi: 10.1111/j.1528-1167.2006.00846.x.

Abstract

Purpose: Valproic acid (VPA) is an antiepileptic drug (AED) commonly used for generalized and focal epilepsies. We provide an update on hepatotoxic side effects in Germany between 1994 and 2003.

Methods: We mailed a questionnaire to all members of the German Section of the International League Against Epilepsy, asking for VPA-induced side effects, especially severe side effects such as hepatopathy.

Results: As a result of our questionnaire, we found 31 cases of reversible hepatotoxicity and nine cases of lethal hepatopathies in Germany from 1994 to 2003.

Conclusions: The outcome of patients with severe hepatotoxicity is better than that in the past. The risk of a VPA-induced hepatopathy is not limited to patients younger than 2 years, receiving polytherapy, or patients with congenital or acquired metabolic diseases.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Anticonvulsants / adverse effects*
  • Anticonvulsants / therapeutic use
  • Chemical and Drug Induced Liver Injury* / epidemiology
  • Chemical and Drug Induced Liver Injury* / etiology*
  • Chemical and Drug Induced Liver Injury* / mortality
  • Child
  • Child, Preschool
  • Comorbidity
  • Drug Therapy, Combination
  • Epilepsy / drug therapy*
  • Epilepsy / epidemiology
  • Fatal Outcome
  • Female
  • Germany / epidemiology
  • Humans
  • Infant
  • Liver Diseases / epidemiology
  • Liver Diseases / mortality
  • Liver Failure / chemically induced
  • Liver Failure / epidemiology
  • Liver Failure / mortality
  • Male
  • Metabolic Diseases / epidemiology
  • Outcome Assessment, Health Care
  • Risk Factors
  • Surveys and Questionnaires
  • Valproic Acid / adverse effects*
  • Valproic Acid / therapeutic use

Substances

  • Anticonvulsants
  • Valproic Acid