Valproate monitoring in epilepsy

Hi all - just for information.

The BNF used to dissuade people from routine valproate monitoring in epilepsy, but I recently noticed that they had changed the relevant section to read:
"Sodium valproate has widespread metabolic effects and monitoring is essential" (see BNF 64, page 298). They meant LFT and FBC monitoring, but it wasn't at all clear from the context.

I wrote to them about this, and am pleased to say that BNF 65 (March-Sept 2013) now says (bottom of page 302): "Sodium valproate has widespread metabolic effects and monitoring of liver function tests and full blood count is essential…. Plasma valproate concentrations are not a useful index of efficacy, therefore routine monitoring is unhelpful."

Small victory - might be useful to some of you in restricting inappropriate requests.

Cheers,

Mike

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