Comparing the Effect of Valproate and Phenobarbital on Weight Gaining of Epileptic Children

Respecting the high incidence of epilepsy among children and several reports coresponding the weight gaining of some during the valproate therapy, this study was conducted in “Mofid Children's Hospital” during 1384 to determine and compare the occurrence and severity of weigh gain among children treated with either valproate or phenobarbital. This clinical trails study was performed studying on 60 epileptic patients. We applied "International League against Epilepsy" classification to diagnose the patients. They were randomly equally divided into two groups (random allocation). First group was treated with valproate 20 mg/kg/day, whereas second one received phenobarbital 5 mg/kg/day [in divided dose]. Patients were followed for a six-month period. Body mass index (BMI) was measured at first, 2nd, 4th and 6th months of therapy and BMI6 was compared with expected BMI6 (according to BMI curve) and the difference of latter two BMIs (BMI6 and expected BMI6) were calculated. McNemar’s test was used to compare the weight difference in each group and Chi-square test was applied for between-groups comparison. In valproate-treated patients whose their weights increased, some characteristics (including age, sex and primary weight) were evaluated by Fisher’s exact test. Two groups were identical with respect to their age, sex, primary BMI and weight. 4 patients of phenobarbital group (13.3%) versus 20 patients of valproate group (66.7%), had weight gain (P=0.6 and P<0.0001, respectively). Final-stage data revealed that compared to phenobarbital, valproate resulted in further weight gaining of children and adolescent (P<0.001). Moreover, in valproate treated group, patients with older age and higher BMI, were more at risk of gaining weight. The risk of weight gainning in epileptic children treated with valproate is high. It seems that in patients above 10 years old and fat patients, this risk become more. We recommend further study to evaluate the effect of valproate on weight of epileptic patients older than 10 years and also fat patients.