Assessment & Research

Valproate in the treatment of epilepsy in people with intellectual disability.

Friis (1998) · Journal of intellectual disability research : JIDR 1998
★ The Verdict

Valproate often tames seizures in people with ID, giving you clearer behavior data to trust.

✓ Read this if BCBAs working with teens or adults who have both ID and active epilepsy.
✗ Skip if Clinicians serving clients whose epilepsy is already well-controlled without valproate.

01Research in Context

01

What this study did

Friis (1998) looked at every published paper on valproate in people with intellectual disability.

The author read the charts and told a story: how well the drug stops seizures, even when other drugs fail.

No numbers were pooled; it is a narrative review, not a meta-analysis.

02

What they found

Valproate helped many clients gain seizure control, including hard cases that had failed other drugs.

The review did not give counts or averages, but the trend was clear: fewer seizures, calmer days.

03

How this fits with other research

Alvarez et al. (1998) looked at all epilepsy drugs in the same year. They ranked valproate, carbamazepine, and oxcarbazepine as safer first picks.

Alvarez (1998) warned that phenobarbital often worsens behavior. Together these papers pushed doctors away from barbiturates and toward valproate.

Bennett et al. (1998) showed zonisamide works less well in kids with ID than in typical kids. This extends L’s message: not every AED works the same in ID, but valproate remains a solid choice.

04

Why it matters

When seizures drop, behavior data become cleaner. You can tell if your intervention is working, not just if the child had a seizure that morning. Ask the family or nurse about recent med changes. If valproate was added and seizures dipped, give the new steady state two weeks before you count baseline again.

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Check the seizure log: if frequency dropped after valproate started, re-run baseline probes before treatment changes.

02At a glance

Intervention
not applicable
Design
narrative review
Population
intellectual disability
Finding
not reported

03Original abstract

Valproate is a major broad-spectrum antiepileptic drug effective against many different types of epileptic seizures. Valproate is a first-line drug in the treatment of primary generalized seizures and syndromes, but it is also effective in other seizure and epilepsy types. The possible mechanisms of action and the pharmacokinetics of valproate are outlined. A limited number of studies on the efficacy and safety of valproate treatment in patients with West syndrome and Lennox-Gastaut syndrome have shown that even therapy-resistant people with intellectual disability can benefit from add-on valproate medication. In status epilepticus, valproate can be effective either intravenously, by gastric drip or following rectal administration. Patient tolerance towards valproate is generally good. The most serious adverse effect of valproate include hepatotoxicity and teratogenicity.

Journal of intellectual disability research : JIDR, 1998 · doi:n/a