Dipropylacetate (Depakine®, Ergenyl®) in the Treatment of Epilepsy

Abstract

SUMMARY A clinical trial with dipropylacetate (DPA), a new anti‐epileptic drug (Dépakine®, Ergenyl®) is reported in 116 patients. Primarily generalized epilepsies ‐ petit mal of different types and centrencephalic grand mal ‐ were mainly benefited. Less favourable results were obtained in epilepsy of focal origin. The side effects were usually minimal, consisting of gastric disturbances. Dipropylacetate increased the effect of other anti‐epileptics, especially barbiturates, primidone and benzodiazepines. Some patients were more alert and their behaviour improved on DPA. RÉSUMÉ On rapporte ľétude clinique de ľeffet du dipropylacétate (DPA) (Dépakine®, Ergenyl®), une nouvelle drogue anti‐épileptique chez 116 sujets. Ce fut surtout bénéfique dans les épilepsies généralisées primaires‐petit mal de différents types et grand mal centrencéphalique. On obtient de moins bons résultats dans ľépilepsie ďorigine focale. Les effets secondaires étaient généralement minimes, consistant en des troubles gastriques. Le dipropylacétate augmentait ľeffet des autres drogues anti‐épileptiques, particulièrement des barbituriques, du primidone et des benzodiazépines. Quelques patients avaient une meilleure conduite et étaient plus réveillés avec le DPA. ZUSAMMENFASSUNG Das Antikonvulsivum Dipropylacetat (Dépakine®, Ergenyl®) wurde bei 116 Patienten erprobt. Die bevorzugte Indikation sind primär generalisierte Epilepsien (Petit mal verschiedenen Typs und sogenanntes zentrenzephales Grand mal). Bei Epilepsien fokaler Genese sind die Erfolge weniger gut. Myoklonische Syndrome bei degenera‐tiven Hirnerkrankungen können günstig beeinflusst werden. Die Nebenwirkungen des Präparates sind insgesamt gering. Dipropylacetat verstarkt die Wirkung anderer Antiepileptica, insbesondere der Barbiturate, des Primidone und der Benzodiazepine. In machen Fällen entfaltet das Präparat eine günstige Wirkung auf das psychische Verhalten der Patienten. RESUMEN Estudio clinico en 116 pacientes con dipropilacetato (DPA), nueva droga antiepiléptica (Depakine®, Ergenyl®). Se han benificiado principalmente de los efectos de esta medicateón las epilepsias generalizadas primarias (diferentes formas de petit mal y gran mal centroencefálico). Se han obtenido resultados menos favorables en la epilepsia de origin focal. La intolerancia ha sido generalmente mínima consistiendo en transtornos gastricos. El dipropilacetato aumenta el efecto de otros antiepilépticos especialmente de los barbitúricos, la Primidona y las benzodiacepinaz. En algunos pacientes ha mejorado su conducta y su vigilancia con DPA.

Sodium Di‐N‐Propylacetate (DPA) in the Treatment of Epilepsy:A Review

“…The alopecia was temporary, not necessitating discontinuation of DPA. Sporadic cases have been observed by others (Kugler et al, 1973;Volzke and Doose, 1973;Klotz, 1974;Penin, 1974), but Kruse (1974) reported that alopecia occurred in 7% of 171 patients treated with DPA.…”

“…Patients receiving DPA in addition to other drugs have been reported rarely to experience slight increases in serum alkaline phosphatase (Suzuki et al, 1972) and transient minor elevations of serum glutamic oxaloacetic transaminase (SGOT) (Volzke and Doose, 1973). There have been no reports of persistent elevations of these enzymes nor of any associated organ damage.…”

“…We placed patients in this classification from the data given or from personal communications with some investigators (Doose, Kerfriden, Matthes, Meinardi, and Sorel, 1974). We combined the types Absence Simple and Absence Complex into one category, because these types of seizures were grouped in two reports that included a large number of patients (Suzuki et al, 1972;Volzke and Doose, 1973), making it impossible to evaluate the seizure types separately. We also combined Atonic and Akinetic seizure types into one category for the same reason; Matthes and Schmutterer (1971) had grouped them in their report.…”

Sodium valproate and cognitive functioning in normal volunteers.

“…In addition, some authors have claimed it exerts a favourable influence on the cognitive state of patients with epilepsy. Following treatment with sodium valproate individuals have been-variously described as being 'more alert', 'more active' and 'more co-operative' and the school performance of children with epilepsy has also been reported to-improve (Volzke & Doose, 1973;Jeavons & Clarke, 1974;Haigh & Forsythe, 1975).…”

Effects of dipropylacetate on brain development

“…DPA was released for treatment of absence seizures, but it has also been used extensively in infants and in young children with other seizure types [ 15,241, including febrile convulsions [2]. Although the drug was initially considered safe, several reports of toxicity in children attributed to DPA treatment have described cases of acute hepatic failure, Reye syndrome, and pancreatitis 19, 12,22,24). I n spite of its prevalent use in infants and young children, the effects of DPA o n development have not been examined.…”