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

Badv, Reza Shervin; Abbasi, Arash; Ashrafi, Mahmoud Reza; Shariatmadari, F.; Bayat, Omid

doi:10.5812/ijp.66083

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…The most notable explanations and mechanisms of nocturnal enuresis include nocturnal polyuria, accompanied disturbances in sleep arousal, 31 valproate may cause changes in renal tubules, 32 limited capacity of the bladder, overactivity of the detrusor muscle, delayed global maturation, and genetics factor. Nocturnal enuresis doubtlessly is a disorder caused by a blend of these etiologies in a multifaceted way.…”

Section: Onset Outcome and Possible Explanations Of Nocturnal Enuresismentioning

confidence: 99%

Sleep Architecture in Valproate-Induced Nocturnal Enuresis in Primary School and Preschool Children

et al. 2020

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Nocturnal enuresis is one of the side effects of valproic acid treatment, and generally underdiagnosed by clinicians. Studies reported that a variable incidence of valproic acid–induced nocturnal enuresis is 2.2% to 24% with unclear explanations of the reasons behind valproic acid–induced nocturnal enuresis. A retrospective study was carried out on 260 children (aged 5-12 years) diagnosed with idiopathic epilepsy, treated with valproic acid to evaluate the nocturnal enuresis secondary to valproic acid, and to discuss the characteristics of their sleep architecture. Nocturnal enuresis was reported in 28 (10.7%) patients after a mean exposure time to valproate of 18.78±8.4 days. Nocturnal enuresis was significantly associated with younger age and serum level of valproate ( P = .05). The polysomnographic study suggested that the underlying mechanism may be related to impaired sleep efficiency, frequent arousals, prolonged sleep latency, snoring, or increased sleep depth which may impair a child’s ability to awaken to the sense of bladder fullness or contractions. Clinical trial registration: ClinicalTrials.gov identifiers: NCT04191863

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Section: Onset Outcome and Possible Explanations Of Nocturnal Enuresismentioning

confidence: 99%

Sleep Architecture in Valproate-Induced Nocturnal Enuresis in Primary School and Preschool Children

et al. 2020

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“…31 A recent study conducted in 2018 in Iran concluded that children with epilepsy, enuresis, and day-urinary frequency are adverse effects of CBZ therapy that should be taken into consideration. 32 To confirm the enuresis induced by CBZ more studies need to be conducted.…”

Section: Antiepileptics Causing Enuresismentioning

confidence: 99%

Antiepileptic Drugs–Induced Enuresis in Children: An Overview

Sathyan

Scaria

Arunachalam

et al. 2020

Journal of Pharmacy Technology

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Objective: To evaluate enuresis-induced antiepileptic drugs in children. Data Sources: A PubMed search (1917 to July 2020) was performed using the following keywords and associated medical subject headings: antiepileptic drugs, enuresis, pediatric population, drug-induced enuresis, and epilepsy. Study Selection and Data Extraction: The search was conducted to find the role of antiepileptic drugs–induced enuresis in children in studies published in English. Data Synthesis: Enuresis or bedwetting is an underreported adverse drug reaction of antiepileptic drugs. Owing to that fact, it is a condition that is outgrown with age and also could cause embarrassment. As antiepileptic drugs sometimes need to be taken for a long duration until epilepsy relapses, the occurrence of enuresis in this situation can be troublesome for both the child and the caretaker. Even though enuresis is proposed to have a significant effect on the child’s psychology, it is still considered to be a condition that is outgrown with age. This article includes a review of antiepileptic drugs reported to have caused enuresis in children. Conclusions: If a child develops enuresis as an adverse drug reaction, this adds further challenges to their life. A better understanding of this potential adverse effect may help prevent unwanted stress. Though the exact mechanisms are not known, the hypothesis generated is from the occurred cases, most of which relapsed when the drug was withdrawn. Considering the gravity of epilepsy in children, more detailed studies need to be conducted on this adverse effect to ensure a safe and effective treatment in children.

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“…Nocturnal enuresis following treatment with VPA occurs rarely. Statistics on the prevalence of enuresis vary widely from 2 to 24% ( 1 , 8 , 9 ). This unwanted effect is easily overlooked as resulting from the seizures themselves, which might mislead to an erroneous decision to increase the dose of VPA.…”

Section: Introductionmentioning

confidence: 99%

Sodium valproate-induced nocturnal enuresis in epilepsy: Three case reports and a review of the literature

Zhang¹,

Lü

2023

Front. Neurol.

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BackgroundEnuresis is an uncommon adverse effect of sodium valproate therapy that is unknown to most clinicians. This study provides an overview of the literature on enuresis associated with sodium valproate therapy, discussing the clinical manifestations and possible mechanisms of this side effect.MethodsWe reported three cases of enuresis induced by sodium valproate and reviewed the published enuresis cases associated with sodium valproate therapy retrieved from databases.Case presentation and resultsThree new patients with epilepsy who presented with enuresis following sodium valproate therapy were reported, and 55 published cases of nocturnal enuresis associated with sodium valproate were evaluated. The average age of these patients varied from 4 to 20 years. A total of 48 cases had generalized seizures, seven had focal seizures, and three had unknown seizures. In all the patients, the plasma concentration of sodium valproate was 80.76 ± 14.80 μg/mL, within the therapeutic range when enuresis occurred. With discontinuation or reduction of the drug, all the patients recovered completely.ConclusionSodium valproate-induced enuresis is a rare and reversible side effect, occurring at a younger age, characterized by the generalized onset of seizures, and a rather high dose. The possible mechanisms include insufficient secretion of anti-diuretic hormones, sleep disorder, and hyperactivity of the parasympathetic system. Clinicians should be aware of this uncommon side effect to avoid an incorrect adjustment of the treatment direction.

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

Cited by 4 publications

References 16 publications

Sleep Architecture in Valproate-Induced Nocturnal Enuresis in Primary School and Preschool Children

Sleep Architecture in Valproate-Induced Nocturnal Enuresis in Primary School and Preschool Children

Antiepileptic Drugs–Induced Enuresis in Children: An Overview

Sodium valproate-induced nocturnal enuresis in epilepsy: Three case reports and a review of the literature

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