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Use, tolerability and outcome of valproate and carbamazepine in treating epilepsies in children and young people: a retrospective clinical audit

Aims Recent pragmatic open label clinical trials suggested Valproate (VPA)1 and Lamotrigine (LAM)2 were the best first line antiepileptic drugs (AEDs), although most participants were adults. We wanted to audit the use and effects of the current first line AEDs VPA and Carbamazepine (CBZ), in children and young people. Methods We undertook a retrospective notes review, with more than 12 months follow-up, of children under 18 years of age, with epilepsies, starting VPA or CBZ 01-11-2007 to 31-10-2010, at one children's hospital. Cases were ascertained from hospital pharmacy records, electronic and paper case records reviewed and data extracted systematically using a standard proforma. Data was entered into a database (SPSS) and simple descriptive statistics used. This method has been used for other AEDs3. The audit was registered with the hospital NHS Trust Audit Department. Results Preliminary data is available for VPA (n=20, 8 male) and CBZ (n=23, 13 male). 8/43 had been exposed to both VPA and CBZ during the audit period. Both were well tolerated, although weight gain (as expected) and behavioural problems (unexpected) were reported on VPA, and allergic rash (as expected) on CBZ (2/23). Data on perceived efficacy and retention will be available in January 2012. Conclusions Preliminary data on 43 children is available and partly analysed, a complete analysis on a larger number of children will be undertaken in January 2012.