摘要
丙戊酸可通过多种机制降低癫痫发作频率,临床常规广泛应用于各种癫痫和癫痫综合征的单药和添加治疗。此外,丙戊酸对于癫痫共患病如偏头痛、精神疾病等也具有显著疗效,在终止癫痫持续状态中也可发挥作用,是临床中常用的广谱类抗癫痫发作药物。但丙戊酸具有致畸、不孕、月经紊乱等副作用,同时,联合用药时要充分考虑药物间的相互作用,因此,在临床应用中需要严格把握其使用指征及用量用法。本文就丙戊酸在不同癫痫发作类型和癫痫综合征、癫痫共患病、颅脑外科术后、癫痫持续状态及特殊人群中的使用,以及丙戊酸与其他药物的联合用药进行综述,为丙戊酸的合理用药及癫痫患者的个体化药物治疗选择提供了依据。
Valproic acid can reduce the frequency of seizures through various mechanisms and is widely used in clinical practice as a monotherapy or adjunctive treatment for various types of epilepsy and epileptic syndromes.In addition,valproic acid has significant therapeutic effects on comorbidities associated with epilepsy,such as migraines and psychiatric disorders.It can also be effective in terminating status epilepticus and is commonly used as a broad-spectrum antieseizure medication in clinical settings.However,valproic acid has side effects such as teratogenicity,infertility,and menstrual disorders.Additionally,when used in combination with other drugs,the interactions between medications should be carefully considered.Therefore,in clinical practice,it is necessary to strictly adhere to the indications and dosage regimens for the use of valproic acid.This article provides a comprehensive review of the use of valproic acid in different types of seizures,epileptic syndromes,comorbidities associated with epilepsy,post-craniotomy cases,status epilepticus,and special populations.It also summarizes the combination therapy of valproic acid with other drugs,providing a basis for the rational use of valproic acid and individualized drug treatment selection for epilepsy patients.
作者
张恩慧
张鹤声
陈雨婕
欧朱净
周东
吴欣桐
ZHANG Enhui;ZHANG Hesheng;CHEN Yujie;OU Zhujing;ZHOU Dong;WU Xintong(Department of Neurology,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《癫痫杂志》
2023年第5期393-399,共7页
Journal of Epilepsy
基金
国家自然科学联合基金项目(U21A20393)
四川省科技厅区域合作项目(23QYCX0088)。
关键词
丙戊酸
癫痫
共患病
联合治疗
不良反应
Valproic acid
Epilepsy
Comorbidities
Combination therapy
Adverse reactions
