Factors associated with subtherapeutic levels of valproic acid in hospitalized patients with epilepsy: A retrospective cohort study

Valproic acid (VPA) is a commonly used anti-seizure medication, owing to its efficacy and cost-effectiveness. However, maintaining appropriate serum levels is crucial due to the narrow therapeutic window, as subtherapeutic levels can lead to treatment failure or adverse outcomes. This study aimed to...

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Bibliographic Details
Published in:Medicine (Baltimore) 2024-11, Vol.103 (45), p.e40488
Main Authors: Boonlue, Tuanthon, Sitsuer, Papitchaya, Phosri, Wasinee, Jinatongthai, Warisara
Format: Article
Language:English
Subjects:
Adult
Aged
Anticonvulsants - administration & dosage
Anticonvulsants - blood
Anticonvulsants - therapeutic use
Drug Monitoring - methods
Epilepsy - drug therapy
Female
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Observational Study
Phenytoin - administration & dosage
Phenytoin - blood
Phenytoin - therapeutic use
Retrospective Studies
Risk Factors
Sex Factors
Valproic Acid - administration & dosage
Valproic Acid - blood
Valproic Acid - therapeutic use
Young Adult
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Summary:Valproic acid (VPA) is a commonly used anti-seizure medication, owing to its efficacy and cost-effectiveness. However, maintaining appropriate serum levels is crucial due to the narrow therapeutic window, as subtherapeutic levels can lead to treatment failure or adverse outcomes. This study aimed to identify the factors associated with subtherapeutic serum levels of valproic acid in patients undergoing treatment. This retrospective cohort study was performed at a tertiary care hospital and involved inpatients aged ≥ 18 years who were receiving valproic acid for epilepsy treatment. Data were obtained through chart reviews and a Therapeutic Drug Monitoring database. Subtherapeutic VPA levels were defined as 
ISSN:1536-5964
0025-7974
1536-5964
DOI:10.1097/MD.0000000000040488