Valproate is associated with early decrease of high-density lipoprotein cholesterol levels in the psychiatric population.
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- doi: 10.1111/bcpt.13580
- issn: 1742-7835
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Therapy Valproate Propylpentanoic acid Sodium valproate Dipropylacetic acid Propylvaleric acidCiter ce document
A. Delacrétaz et al., « Valproate is associated with early decrease of high-density lipoprotein cholesterol levels in the psychiatric population. », Serveur académique Lausannois, ID : 10.1111/bcpt.13580
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Few studies have evaluated the influence of valproate on the deterioration of the lipid profile in psychiatric patients. This observational study aimed to compare the evolution of metabolic parameters in a sample of adult patients starting valproate (n = 39) with a control group (n = 39) of patients starting aripiprazole, a drug associated with a low risk of metabolic deterioration. Data were obtained from a prospective study including psychiatric patients with metabolic parameters monitored during the first year of treatment. During the first month of treatment with valproate (median: 31 days [IQR: 25-36]), mean body mass index increased significantly (from 24.8 kg/m 2 at baseline to 25.2 kg/m 2 after one month; P = .03) and mean HDL-C levels decreased significantly (from 1.39 mmol/L to 1.27 mmol/L; P = .02). In comparison, these metabolic variables remained stable during the first month of treatment with aripiprazole. The proportion of patients with early (ie during the first month of treatment) HDL-C decrease of ≥ 5% was significantly higher under valproate (54%) than aripiprazole (15%) treatment (P < .001). These findings remind the importance of a prospective metabolic monitoring in patients who initiate valproate treatment. Further research should be conducted on larger samples and should focus on finding effective interventions to prevent such metabolic adverse effects.