Valproate is associated with early decrease of high‐density lipoprotein cholesterol levels in the psychiatric population. Issue 1 (25th March 2021)

• Record Type: Journal Article
• Authors: Delacrétaz, Aurélie; Glatard, Anaïs; Dubath, Céline; Gholam, Mehdi; Gamma, Franziska; von Gunten, Armin; Conus, Philippe; Eap, Chin B.
• Is Part Of: Basic & clinical pharmacology & toxicology. Volume 129:Issue 1(2021)
• Page Start: 26
• Page End: 35
• Publication Date: 2021-03-25
• Subjects: anticonvulsants -- dyslipidaemia -- epilepsia -- obesity -- psychopharmacology; Pharmacology -- Periodicals; Toxicology -- Periodicals; Pharmacology -- Periodicals; Toxicology -- Periodicals; Pharmacology, Clinical -- Periodicals; Computer network resources; Electronic journals; 615.1
• DOI: 10.1111/bcpt.13580
• Languages: English
• ISSNs: 1742-7835

Abstract

Abstract: 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.