丙戊酸钠:化身博士和海德先生

J. Bossu
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摘要

丙戊酸钠(VPA)是一种结构非常简单的化合物,由植物 - œValeriana officinalis -产生的戊酸衍生而来。这种植物的提取物被古希腊医生用来治疗失眠,罗马人用来治疗心悸和心律失常。VPA于1963年首次被用作抗惊厥药,1974年Jevson和Clark在对63例患者(其中40例对其他抗惊厥药无效)进行临床研究后得出结论,43%的患者癫痫完全停止,22%的患者癫痫发作减少50%。一个不寻常的副作用是暂时性脱发。从那时起,VPA被广泛用于治疗几乎所有类型的癫痫发作和癫痫综合征,并成功地用于对其他药物产生抗性的癫痫患者。在其抗惊厥作用的背后,VPA还针对广泛的神经系统疾病,包括一些神经退行性病变、成瘾、双相情感障碍和强迫症以及偏头痛。
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The Sodium Valproate: Doctor Jekyll and Mister Hyde
The sodium valproate (VPA) is a very simple structural compound derived from the valeric acid produced by a plant “Valeriana officinalis†. Extract s of this this plant were used by the doctors of Ancient Greece to cure insomnia and by the Romans to treat palpitations and arrhythmia. VPA was used for the first time as an anticonvulsant in 1963 [1] and in 1974 Jevson and Clark [2] after their clinical study on 63 patients whom 40 of them had failed to respond to other anticonvulsants concluded that in 43% of patients, epilepsy stopped completely, and in 22% of patients, the attacks were reduced by 50%. An unusual side effect was temporary hair loss. Since then VPA is widely used to treat almost all types of seizures and epilepsy syndromes, and is used successfully, for patients displaying epilepsy resistant to other medications [3]. Behind its anticonvulsants effect, VPA targets also a wide range of neurological diseases including some neurodegenerative pathologies, addiction, bipolar and obsessive-compulsive disorders and migraine [4].
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