The effects of valproate (VPA) in 40, carbamazepine (CBZ) in 19, and oxcarbazepine (OXC) in 18 girls with epilepsy on growth and maturation were compared to 49 healthy untreated controls examined at 8 to 18 years of age at the Departments of Neurology, Pediatrics, and Radiology, University of Oulu, Finland. VPA, CBZ, or OXC did not affect linear growth, followed longitudinally from the age of 1 year, or pubertal development. An increase in weight in VPA-treated girls occurred in those starting treatment either before or during puberty, and was not associated with hyperinsulinemia. High circulating concentrations of plasma insulin-like growth factor-1 in girls taking CBZ or OXC were of uncertain significance, and unassociated with abnormal weight gain. [1]

COMMENT. Neither VPA medication itself nor the associated weight gain affect linear growth or pubertal development of girls with epilepsy. Hyperinsulinemia, reported in obese adult women taking VPA for epilepsy, is not observed in girls treated for an average of 2.8 years. Weight gain in girls treated with VPA is slow and progressive and should be monitored regularly. These authors have reported on valproate-induced obesity and polycystic ovarian syndrome in women with epilepsy (see Progress in Pediatric Neurology III, 1997).