Sodium valproate induced increased frequency of micturition and enuresis

Gosavi, Devesh D; Suman, Akanksha; Jain, Manish

doi:10.4103/0253-7613.106443

Cited by 13 publications

(13 citation statements)

References 9 publications

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“…Furthermore, the mean daily dose of valproate was not significantly different among children who developed this adverse event and those who did not, a finding that suggests that the occurrence of secondary enuresis is not dose related. Data from individual case reports suggest that, at least in some children, nocturnal enuresis is dose related since it was noted only when valproate dose was increased …”

Section: Discussionmentioning

confidence: 99%

“…Some previous studies and case reports evaluating the adverse events associated with valproate mentioned enuresis as a possible side effect of this drug with a frequency, when reported, ranging between 2% and 7%. [7][8][9][10][11]14,15 In a retrospective study of 100 children, which evaluated the frequency and amount of weight gain after exposure to valproate, nocturnal enuresis was reported in 7% of participants; however, further details, other than the fact that enuresis spontaneously abated after a few months, were not provided. 7 In a prospective comparative trial of phenobarbital, primidone, and valproate for the prevention of febrile seizures, 1 child out of 48 children (2%) exposed to valproate was reported to have developed enuresis.…”

Section: Discussionmentioning

confidence: 99%

“…Data from individual case reports suggest that, at least in some children, nocturnal enuresis is dose related since it was noted only when valproate dose was increased. 10,14,15 Drug-induced secondary enuresis is an uncommon adverse event that has mainly been described after treatment with atypical antipsychotics. This class of drugs has been reported to induce secondary enuresis in 21%, 10%, 7%, and 6% of patients aged 15 to 64 years treated with clozapine, olanzapine, quetiapine, and risperidone, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Valproate‐induced enuresis: a prospective study

Yamak

Hmaimess

Makke

et al. 2015

Develop Med Child Neuro

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AIM The aim of this study was to determine the frequency and characteristics of secondary enuresis in children initiated on valproate treatment.METHOD This was a prospective study conducted in children aged 5 to 12 years with suspected newly diagnosed epilepsy and maintained on valproate for at least 1 month. Adverse events spontaneously reported by parents were recorded at each follow-up visit. In addition, we specifically asked about enuresis and other side effects known to occur with valproate treatment. We assessed the frequency of enuresis and its association with a number of variables.RESULTS Seventy-two children (43 males and 29 females) with a mean age of 8 years 7 months (range 5-12y) were included in this study. Secondary enuresis developed in 17 (24%) of these children after, on average, 19.8 days of exposure to valproate. The data obtained from a multivariate analysis indicate that age was the only significant factor in predicting the development of enuresis. Enuresis ceased in all children after discontinuation of valproate use, and in 10 out of 11 children still on the drug.INTERPRETATION Secondary enuresis is a common adverse event associated with valproate use in children, which is not usually spontaneously reported and is reversible in most cases.Valproate is a broad-spectrum antiepileptic drug approved as monotherapy and adjunctive therapy for the treatment of simple and complex partial seizures in adults and children 10 years or older; as adjunctive therapy for the treatment of multiple seizure types, including absence seizures; for the treatment of acute manic episodes in those with bipolar disorder older than 18 years of age; and as a prophylactic agent for migraine headaches in adults and children older than 16 years.1 Adverse events associated with valproate include idiosyncratic reactions, such as hepatotoxicity and pancreatitis, and dose-related adverse events including weight gain, hair thinning, tremor, drowsiness, nausea, vomiting, ataxia, and thrombocytopenia. [2][3][4] Primary and secondary nocturnal enuresis is common in children, with a peak prevalence of 15% to 25% at age 5 years.5 Although enuresis typically disappears as the child matures, it can be distressing for children and their families and can prompt treatment with desmopressin or imipramine, or behavioural interventions. 5,6 An association between the emergence of enuresis and treatment with valproate has been suggested but is not well characterized in the literature.7-11 A recently published review, which comprehensively described the adverse events of valproate, failed to mention enuresis as a side effect of this drug. 12In this study, we prospectively assessed the frequency of enuresis in children with suspected newly diagnosed epilepsy, naive to antiepileptic drug treatment, and initiated on valproate. We also attempted to elucidate the characteristics of and the risk factors for the development of valproate-induced enuresis. METHODChildren eligible for this study were identified from those already enrolled in an on...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Valproate‐induced enuresis: a prospective study

Yamak

Hmaimess

Makke

et al. 2015

Develop Med Child Neuro

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“…According to the literature, these side effects are more likely to occur in patients who require dosage increase. Despite these reports, there is a lack of solid evidences on association of urinary complications with sodium valproate and thus these complications are not known as side effects of this drug (11,13,14). Egger and Brett performed a retrospective study on the side effects of sodium valproate on epileptic children focusing on weight gain, they showed that among 100 cases, only 7% exhibited enuresis as a side effect (15).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Sodium Valproate on Urinary Frequency and Enuresis Compared to Carbamazepine in Children with Epilepsy

et al. 2018

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Background: Sodium valproate is one of the widely used medications in the treatment of children with epilepsy. The aim of this study was to evaluate the possible role of sodium valproate on enuresis and urinary frequency in epileptic children in comparison to carbamazepine. Methods: In this prospective cohort study, we enrolled epileptic children aged 5 to 14 years who met the exclusion criteria and were under monotherapy with sodium valproate or carbamazepine. All the cases were assessed for urinary complications during a period of one-year follow-up. Patients with urinary complications were tested for urinary tract infection and also for any urogenital anatomical abnormalities to avoid possible false positive results. Results: From 290 patients who met the inclusion criteria, 254 cases were studied. It was showed that among 127 patients in sodium valproate group, 14 (11.02%) cases had enuresis while in 4 cases it was accompanied by urinary frequency. Among these 14 cases, 10 were treatment naives (new cases) (symptoms appeared after 6.1 ± 1.4 weeks) and the other four only had their medication dosage increased (symptoms appeared after 3.2 ± 0.9 weeks). In three cases, the dosage was reduced and in one case a medication was replaced with another. In all patients, however, the symptoms subsided within 10 -30 days. On the other hand, no urinary complication was found in the carbamazepine group. Conclusions:The results demonstrated that in children with epilepsy, enuresis and day-urinary frequency are two side effects of valproate and carbamazepine therapy that should be taken into consideration.

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“…Our literature search identified 14 case reports that described the induction of enuresis in children with epilepsy who were treated with SV, but there was an absence of literature examining nonepileptic patients 4–9. Moreover, none of the patients presented with diurnal enuresis.…”

Section: Discussionmentioning

confidence: 99%

Sodium valproate-induced enuresis in a pediatric bipolar patient

Cheng¹,

Lin²,

Lu³

2013

NDT

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Sodium valproate (SV) is effective and well tolerated for the treatment of epilepsy and mood disorders. There are several cases of SV-induced enuresis noted in epileptic patients. No alternative medication has been suggested to manage this problem. We present the first case of a pediatric bipolar patient who developed diurnal and nocturnal enuresis during SV therapy. Clinicians should be aware of this side effect, as it has not been reported in nonepileptic patients, and it may be detrimental to treatment adherence.

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Sodium valproate induced increased frequency of micturition and enuresis

Cited by 13 publications

References 9 publications

Valproate‐induced enuresis: a prospective study

Valproate‐induced enuresis: a prospective study

The Effect of Sodium Valproate on Urinary Frequency and Enuresis Compared to Carbamazepine in Children with Epilepsy

Sodium valproate-induced enuresis in a pediatric bipolar patient

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