Chrono Impact versus Enteric Coated Valproate in Thai Epileptic Patients
Somchai Towanabut MD*, Somsak Tiemkao MD**, Suwanna Thammasupapong MD***, Ram Kijjarak MD***, Arkhom Arayawichanon MD****, Niphon Poungvarin MD*****, Sasithron Sirimaharaj MD******, Rungsan Chaisewikul MD*****, Thanin Asawavichenjinda MD*******, Sakarin Maneesuk MD********, Orawan Silpakit MD*********
Affiliation : * Department of Neurology, Prasat Neurological Institute ** Department of Medicine, Faculty of Medicine, Srinagarin Hospital, Khon Kaen *** Department of Medicine, Prapokklao Hospital, Chantaburi **** Department of Medicine, Sapprasittiprasong Hospital, Ubolrachatanee ***** Department of Medicine, Faculty of Medicine, Siriraj Hospital ****** Department of Medicine, Prasatchiangmai Hospital, Chiangmai ******* Department of Medicine, Nakornrajchasrima Hospital, Nakornrajchasrima ******** Department of Surgery, Trang Hospital, Trang ********* Department of Medicine, Sritanya Hospital
Background : Since its first clinical use more than 30 years ago, Valproic acid is still being widely prescribed.
It has been available in Thailand for more than 20 years. Sodium valproate slow-released (SVSR) form has
been used in clinical practice in Thailand since 1990. The objectives of this open study were to access the
compliance and satisfaction consequences in the epileptic patients.
Materials and Methods : In this prospective, multi-center study, the authors compared the compliance and
satisfaction consequences in epileptic patients switched from more than two times daily sodium valproate
enteric-coated tablet (SVEC) regimen to the same total daily dose of SVSR form given once or twice daily.
Results : Eighty-nine of the 100 patients completed the study. 43.8% were male (39 of 89 patients). Mean age
was 34.74 + 12.67 years. Most common etiology of epilepsy was idiopathic 40.4%. Patients were very/fairly
happy with the SVSR form 94.4% compared to the SVEC form 56.2% (p = 0.000). Patients had been experienc-
ing no problem with the SVSR form 67.4% compared to SVEC form 38.2% (p = 0.000) and also never missing
taking SVSR. form 77.5% compared to SVEC form 40.4% (p = 0.000). According to convenience, patients
preferred to administer SVSR form once a day 92.1% and never over taking dosed the antiepileptic drug
96.6%. SVSR form had fewer side effects than the enteric-coated form interms of memory problem (40.4% vs
48.3%) (p = 0.000), sleepiness (30.3% vs 42.7%) (p = 0.041) and difficulty in thinking clearly (38.2% vs
44.9%) (p = 0.001). The patients were seizure free during the study period comparing SVSR form 76.4% to
SVEC form 65.2% (p = 0.011).
Conclusion : Patients preferred once daily regime. Switching from SVEC to SVSR form increased seizure free,
reduced side effects, improved patient’s compliance and satisfaction.
Keywords : Epilepsy, Sodium valproate, Compliance, Anti-epileptic therapy
