Sodium valproate for epilepsy in rural China: an efficacy and safety assessment in primary care.

PURPOSE

Sodium valproate (VPA) is a broad-spectrum anti-epileptic drug usually well tolerated. We conducted a pilot study to assess the feasibility, efficacy and side-effects of VPA in the treatment of convulsive epilepsy in primary care settings in rural China as an alternative to phenobarbital.

METHODS

People with convulsive epilepsy were identified at primary health care level and provided with VPA monotherapy. Local trained physicians identified participants, managed treatment, and carried out the follow-up, whilst diagnoses were confirmed by a neurologist. Participants were followed for 12 months. Efficacy was assessed from the percentage reduction in seizure frequency and by retention of treatment. Tolerability was assessed by reports of treatment-emergent effects.

RESULTS

Of 532 people enrolled, 512 completed the assessment. Most (431 people, 84%) had a decrease in seizure frequency of at least 50% and 218 became seizure-free. Treatment retention was 96% at one year. VPA was well tolerated and only 47 people reported adverse events which were mostly mild. Only two people discontinued VPA due to side-effects.

CONCLUSION

In this 12-month assessment, VPA had favourable efficacy, few side effects and overall good acceptability. It was also relatively cheap. VPA is, therefore, a suitable alternative to phenobarbital as treatment of convulsive epilepsy in rural areas of China.