Chronic valproate administration reduces fasting ketonemia in children

We previously found that chronic administration of sodium valproate to suckling infant mice reduced plasma β-hydroxybutyrate levels but had no effect on plasma free fatty acid or glycerol concentrations. We now report that valproate has a similar effect in children taking the drug for epilepsy. In larger doses, valproate also depleted the infant mouse liver glycogen content. These findings may relate to the hepatic toxicity of valproate. We advise caution if the drug is being considered for use in chronically malnourished children or when the caloric intake of normal children is likely to be reduced during periods of acute illness.