The Effect of Sodium Valproate on Urinary Frequency and Enuresis Compared to Carbamazepine in Children with Epilepsy

Sodium valproate is one of the widely used medications in the treatment of children with epilepsy. The aim of this study was to evaluate the possible role of sodium valproate on enuresis and urinary frequency in epileptic children in comparison to carbamazepine. In this prospective cohort study, we enrolled epileptic children aged 5 to 14 years who met the exclusion criteria and were under monotherapy with sodium valproate or carbamazepine. All the cases were assessed for urinary complications during a period of one-year follow-up. Patients with urinary complications were tested for urinary tract infection and also for any urogenital anatomical abnormalities to avoid possible false positive results. From 290 patients who met the inclusion criteria, 254 cases were studied. It was showed that among 127 patients in sodium valproate group, 14 (11.02%) cases had enuresis while in 4 cases it was accompanied by urinary frequency. Among these 14 cases, 10 were treatment naives (new cases) (symptoms appeared after 6.1 ± 1.4 weeks) and the other four only had their medication dosage increased (symptoms appeared after 3.2 ± 0.9 weeks). In three cases, the dosage was reduced and in one case a medication was replaced with another. In all patients, however, the symptoms subsided within 10 - 30 days. On the other hand, no urinary complication was found in the carbamazepine group. The results demonstrated that in children with epilepsy, enuresis and day-urinary frequency are two side effects of valproate and carbamazepine therapy that should be taken into consideration.