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February 1, 1980

Valproic Acid in Epilepsy

Author Affiliations

University of Maryland School of Medicine Baltimore

JAMA. 1980;243(5):431. doi:10.1001/jama.1980.03300310019008

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To the Editor.—  It is interesting to read in The Journal that Livingston et al (241:1892, 1979) found valproic acid to be "of little or no benefit in grand mal, psychomotor, or myoclonic epilepsy of older children." Our experience in a group of 46 mentally retarded patients, ranging in age from 2 to 57 years and receiving valproic acid in dosages of 15 to 75 mg/kg/day in a period of from two to 16 months, is different but fortunately encouraging. In all patients valproic acid was added to the existing anticonvulsant regimen, and the dosage was increased gradually until seizure control was obtained, the medication was considered ineffective, or signs of toxic reaction appeared.The patients had intractable seizures and were refractory to the standard anticonvulsant medication, whether administered singly or in different combinations. The types of epilepsy were as follows: generalized tonic-clonic seizures (grand mal), 30 patients; generalized tonic-clonic