Abstract
Background
Although clinical experience has demonstrated the effects of antiepileptic drugs such as valproic acid (VPA) on mood swings, irritability and sleep disorders, there is not enough evidence available supporting this.
Aims & Objectives
Here, we studied the effects of VPA on irritability, compulsiveness and sleep disorders in developmental disorders particularly autism spectrum disorder (ASD).
Method
Subjects comprised adults and children with developmental disorders, excluding cases with comorbidity of epilepsy who visited our developmental disorder clinic between September 2011 and September 2021. We retrospectively studied symptoms such as irritability, compulsiveness and sleep disorders, electroencephalography (EEG) at sleep onset, drug administration and pharmaco-therapeutical effects of low dose VPA administration from medical records. We evaluated therapeutic effects by assessing symptomatic changes during the day and improvement of the sleep disorder using the Clinical Global Impressions (CGI-I). We also comparatively studied the results of EEG before and after administration of the drug. Consent was obtained from the patients, or their family and this study was approved by the institutional review board.
Results
The male to female ratio between the total 280 patients who were administered VPA was 202: 48, and the ages of subjects ranged from 3 years to 34 years. The mean age was 13.4 years. Abnormalities in EEG at sleep onset were observed in 84.5%, and high-voltage sharp waves/slow-waves were observed in the frontal region in many cases. There were 87% whose symptoms during the day improved after starting low dose VPA therapy. In terms of changes in sleep orders before and after starting VPA, we observed that out of the 82.8% who had sleep disorders before starting the drug, improvement was seen in 91.6%. Administration of the drug was discontinued in 44 cases before the end of the study for reasons such as exacerbated irritability or hyperphagia.
Discussion & Conclusions
We observed improvement in problems such as behavioral issues and sleep disorders as a result of administering low dose VPA to subjects with developmental disorders particularly ASD. VPA may improve symptoms accompanying developmental disorders, and prospective studies, among other types of research, needs to be conducted to accumulate data on more cases.