Fabrication of extended-dissolution divalproex tablets: a green solvent-free granulation technique.
This study aims to produce stable taste masked divalproex sodium once daily tablets using solvent free hot melt granulation process.Methods: A lab scale high shear mixer granulator employing six meltable lipid binders (compritol®888 ATO, beeswax, gelucire®50/13, precirol® ATO5, stearyl alcohol, and geleol®) were used for the preparation of tablets. Quality control tests were performed on granules and tablets, and Box Behnken design was adopted to investigate the effect of binder concentration, impeller speed, and granulation time on the drug dissolution. Shelf and accelerated stability evaluation, taste ass...
Source: Drug Development and Industrial Pharmacy - May 6, 2020 Category: Drugs & Pharmacology Tags: Drug Dev Ind Pharm Source Type: research

Eptinezumab (Vyepti) for Migraine Prevention
Date: June 1, 2020 Issue #:  1599Summary:  The FDA has approved eptinezumab-jjmr (Vyepti– Lundbeck), a calcitonin gene-related peptide (CGRP) antagonist administered IV once every 3 months, for migraine prevention in adults. It is the fourth monoclonal antibody to be approved for this indication; erenumab (Aimovig), fremanezumab(Ajovy), and galcanezumab (Emgality), which are all given subcutaneously once monthly (fremanezumab can also be given once every 3 months), were approved earlier. (Source: The Medical Letter)
Source: The Medical Letter - April 29, 2020 Category: Drugs & Pharmacology Authors: admin Tags: Aimovig Ajovy Amitriptyline Atacand Atenolol Beta blockers Bisoprolol Botox Candesartan Corgard Cymbalta Depakote Duloxetine Effexor Emgality Epival eptinezumab erenumab fremanezumab galcanezumab Inderal Lopressor Source Type: research

Stepped Treatment for Attention-Deficit/Hyperactivity Disorder and Aggressive Behavior: A Randomized, Controlled Trial of Adjunctive Risperidone, Divalproex Sodium, or Placebo After Stimulant Medication Optimization
This study compared the efficacy in reducing aggressive behavior of risperidone (RISP), divalproex sodium (DVPX), and placebo (PBO) added to stimulant medication among children whose symptoms persisted after individually-optimized stimulant treatment. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - January 29, 2020 Category: Psychiatry Authors: Joseph C. Blader, Steven R. Pliszka, Vivian Kafantaris, Carmel A. Foley, Gabrielle A. Carlson, Judith A. Crowell, Brigitte Y. Bailey, Colin Sauder, W. Burleson Daviss, Christa Sinha, Thomas L. Matthews, David M. Margulies Tags: New Research Source Type: research

Combination of Olanzapine and Samidorphan Has No Clinically Significant Effect on the Pharmacokinetics of Lithium or Valproate
ConclusionsConsistent with previously reported findings on olanzapine, administration of multiple doses of OLZ/SAM did not have a clinically significant effect on the pharmacokinetics of lithium or valproate. Co-administration of OLZ/SAM and lithium or valproate was generally well tolerated; the safety profile of OLZ/SAM was consistent with that observed in previous clinical studies. (Source: Clinical Drug Investigation)
Source: Clinical Drug Investigation - October 3, 2019 Category: Drugs & Pharmacology Source Type: research

19.3 treatment of early age mania (team)
Lithium is one of the oldest treatments for bipolar disorder and was recently studied as part of the Treatment of Early Age Mania (TEAM) study in a head-to-head comparison with divalproex sodium and risperidone. This presentation will examine the outcomes for youth assigned to lithium in the initial 8-week trial. We will also examine youth switched to lithium after failing another treatment or partial responders who received lithium as an add-on (combination) treatment with one of the other 2 agents. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - September 30, 2019 Category: Psychiatry Authors: Adelaide Robb Tags: Clinical Perspectives 19 Source Type: research

Use of meropenem to treat valproic acid overdose
We present a case of VPA overdose managed with meropenem in addition to levocarnitine. A 38-year old female presented to the emergency department after intentionally ingesting 20 tablets of extended release divalproex sodium. (Source: The American Journal of Emergency Medicine)
Source: The American Journal of Emergency Medicine - September 3, 2019 Category: Emergency Medicine Authors: Diane Dreucean, Kevin Beres, Afton McNierney-Moore, Dante Gravino Source Type: research

Fast liquid chromatography-tandem mass spectrometry method for simultaneous determination of eight antiepileptic drugs and an active metabolite in human plasma using polarity switching and timed selected reaction monitoring
Publication date: Available online 17 August 2019Source: Journal of Pharmaceutical and Biomedical AnalysisAuthor(s): Maureen A. KaneAbstractA fast liquid chromatography-tandem mass spectrometry method using polarity switching and timed selected reaction monitoring has been developed and validated to quantify eight antiepileptic drugs and an active drug metabolite in human plasma within a single analytical assay. The antiepileptic drugs include levetiracetam, lamotrigine, zonisamide, topiramate, carbamazepine, phenytoin, divalproex sodium, oxcarbazepine, and the oxcarbazepine active metabolite 10,11-dihydro-10-hydroxycarbam...
Source: Journal of Pharmaceutical and Biomedical Analysis - August 18, 2019 Category: Drugs & Pharmacology Source Type: research

Divalproex sodium regulates ataxin-3 translocation likely by an importin α1-dependent pathway
Nuclear localization of ataxin-3 plays a fundamental role in seeding aggregation and the pathology of spinocerebellar ataxia type 3 (SCA3). However, very few compounds that are able to modulate the nuclear transport of ataxin-3 have been identified. In our previous study, we found that divalproex sodium (DVS) reduced heat shock-induced nuclear localization of ataxin-3. However, the mechanism of DVS in the translocation of ataxin-3 still remains unknown. There is accumulating evidence that importins are regulated by acetylation, and histone deacetylase inhibitors can interrupt this process. With this in mind, we used cells ...
Source: NeuroReport - July 2, 2019 Category: Neurology Tags: Degeneration and Repair Source Type: research

New Trends in Migraine Pharmacology: Targeting Calcitonin Gene –Related Peptide (CGRP) With Monoclonal Antibodies
This study aims at investigating the still poorly clear pathogenesis of migraine and the potential role of anti-CGRP mAbs in the scenario of prophylaxis of migraine. Introduction: Migraine Clinic Migraine consists in unilateral headache accompanied by a cluster of other sensory, autonomic and cognitive symptoms and it has been identified by the global burden of disease (GBD) study 2016 as the sixth most prevalent disorder and one of the main causes of disability all over the world, often occuring in working age and in young adult and middle-aged women (Collaborators, 2018). Hence, migraine represents a very serious...
Source: Frontiers in Pharmacology - April 8, 2019 Category: Drugs & Pharmacology Source Type: research

Current Status of Antiepileptic Drugs as Preventive Migraine Therapy
This article specifically provides the following: (1) a review of the mechanism of action, efficacy, and tolerability of topiramate and divalproex sodium/sodium valproate, the most widely used AEDs for migraine prevention, (2) a discussion on emerging evidence regarding the efficacy of zonisamide and levetiracetam, and (3) comments on gabapentin, pregabalin, carbamazepine, oxcarbazepine, and lamotrigine, AEDs which have insufficient evidence for use in migraine prevention.Recent findingsThe potential role for new extended-release formulations of topiramate in migraine prevention is discussed.SummaryThere is substantial evi...
Source: Current Treatment Options in Neurology - March 17, 2019 Category: Neurology Source Type: research

Pharmacologic Prevention of Migraine: A Narrative Review of the State of the Art in 2018.
Abstract This paper describes current non-antibody pharmacologic approaches to the prevention of migraine in adults. Preventive therapy should be considered for patients with migraine who routinely have more than 6 headache days per month or in other special circumstances. Choices for preventive therapy are based on patient preferences about side effects and evidence of efficacy. The evidence level and commonly used doses for selected categories of migraine preventive medication are reviewed, including antiepileptic drugs, antihypertensive drugs, and antidepressants. Propranolol, timolol, topiramate, and divalproe...
Source: Headache - August 23, 2018 Category: Neurology Authors: Loder E, Rizzoli P Tags: Headache Source Type: research

Determinants of free serum valproate concentration: A prospective study in patients on divalproex sodium monotherapy
ConclusionsAn increase in the total VPA concentration results in corresponding linear and non-linear rise in the VPA free fraction and free VPA concentration, respectively. The total daily dose of VPA should be increased in smaller increments whenever a total VPA concentration of 60 μg/mL is reached. When drug monitoring is needed, we recommend measuring the free VPA concentration. If this test is unavailable, and for patients with normal albumin levels, it can be predicted from the total VPA concentration using the generated equation. (Source: Seizure)
Source: Seizure - July 10, 2018 Category: Neurology Source Type: research

Determinants of free serum valproate concentration: A prospective study in patients on divalproex sodium monotherapy
(Source: Seizure: European Journal of Epilepsy)
Source: Seizure: European Journal of Epilepsy - April 23, 2018 Category: Neurology Authors: Wassim Nasreddine, Maya Dirani, Samir Atweh, Achraf Makki, Ahmad Beydoun Source Type: research

Time Course of Reversal of Valproate-Mediated Inhibition of Lamotrigine
Conclusions These observations demonstrate that the pharmacokinetic interaction between LTG and VPA is reversible, and that de-inhibition appears to follow a predictable time course. Complete offset, or reversal of this interaction takes place 10–14 days after VPA discontinuation. Our data also confirms the observation that LTG oral clearance may be inhibited by very low concentrations of VPA. These data support the conversion algorithm suggested by the manufacturer, and provide guidance to the clinician. These data provide clinically useful information in developing a dosing algorithm for converting patients to LT...
Source: Seizure - March 16, 2018 Category: Neurology Source Type: research

Divalproex sodium modulates nuclear localization of ataxin-3 and prevents cellular toxicity caused by expanded ataxin-3.
CONCLUSION: Our study provides novel insights into the mechanisms of action of divalproex sodium as a possible treatment for SCA3, beyond the known regulation of transcription. PMID: 29318784 [PubMed - as supplied by publisher] (Source: CNS Neuroscience and Therapeutics)
Source: CNS Neuroscience and Therapeutics - January 9, 2018 Category: Neuroscience Authors: Wang ZJ, Hanet A, Weishäupl D, Martins IM, Sowa AS, Riess O, Schmidt T Tags: CNS Neurosci Ther Source Type: research

Application of Spray Drying Technique for Flowability enhancement of Divalproex Sodium
Conclusion Findings suggest that the spray drying technique improves DVX flowability and may pave the way for improvement in the tabletting procedure of DVX. [...] © Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Drug Research)
Source: Drug Research - September 12, 2017 Category: Drugs & Pharmacology Authors: Ghanbarzadeh, Saeed Valizadeh, Hadi Yaqoubi, Shadi Asdagh, Arash Hamishehkar, Hamed Tags: Original Article Source Type: research

Intermittent Transient Motor Aphasia in Acute Lithium Toxicity: A Case Report and Brief Review.
CONCLUSION: Clinicians should be aware of this rarely reported side effect of lithium particularly in patients at risk for volume depletion and closely monitor fluid intake, lithium level, and potential side effects. PMID: 28571548 [PubMed - as supplied by publisher] (Source: Current Drug Safety)
Source: Current Drug Safety - May 31, 2017 Category: Drugs & Pharmacology Authors: Madhusoodanan S, Reddy V, Mohan S Tags: Curr Drug Saf Source Type: research

Valproate-Induced Hyperammonemic Encephalopathy in General Hospital Patients With One or More Psychiatric Disorders
Divalproex sodium/valproic acid (VPA) is an antiepileptic drug approved for use in epilepsy and bipolar disorder. Valproate-induced hyperammonemia occurs in up to 50% of VPA-treated patients, some of whom may become encephalopathic. Valproate-induced hyperammonemic encephalopathy (VHE) is thought to be rare, and for a variety of reasons, the diagnosis requires a high index of suspicion. (Source: Psychosomatics)
Source: Psychosomatics - February 23, 2017 Category: Psychiatry & Psychology Authors: Chandani Lewis, George E. Tesar, Roman Dale Tags: Original Research Reports Source Type: research

Valproate-induced Hyperammonemic Encephalopathy (VHE) in General Hospital Patients with one or more Psychiatric Disorders ☆
Divalproex sodium/valproic acid (VPA) is an antiepileptic drug approved for use in epilepsy and bipolar disorder. Valproate-induced hyperammonemia (VHA) occurs in up to 50 % of VPA-treated patients, some of which may become encephalopathic. Valproate-induced encephalopathy (VHE) is thought to be rare, and for a variety of reasons the diagnosis requires a high index of suspicion. The study ’s goals are to determine how common VHE is, and the quality of treatment provided when diagnosed. (Source: Psychosomatics)
Source: Psychosomatics - February 22, 2017 Category: Psychiatry & Psychology Authors: Chandani Lewis, George E. Tesar, Roman Dale Tags: Original Article Source Type: research

Using a graphical risk tool to examine willingness to take migraine prophylactic medications
Abstract: Many migraine sufferers use daily prophylactic therapy to reduce the frequency of their headache attacks. The Food and Drug Administration has approved several different medications for migraine prophylaxis, but it is not clear whether sufferers perceive these treatments to provide clinically significant benefits given their side effect profiles. Three hundred headache sufferers were recruited from the community and local headache clinics using print and television advertising. Participants reported experiencing problematic headache attacks with a median (IQR) frequency of 7.0 (4-13) headache days per month. Thes...
Source: Pain - September 27, 2016 Category: Anesthesiology Tags: Research Paper Source Type: research

Pharmacotherapy of conduct disorder: Challenges, options and future directions
There is a critical need for evaluation of the pharmacotherapies used in conduct disorder (CD), due to the high incidence of off-label prescribing. The aim of this review was to identify concerns associated with the safety, efficacy and impact on quality of life (QOL) that pharmacotherapy has in children and adolescents with CD. A systematic review was undertaken using pre-defined search criteria and four databases, including reference searches. We assessed these studies using the Strength of Recommendation Taxonomy, Grading of Recommendations Assessment, Development and Evaluation, and Review Manager Risk of Bias (RevMan&...
Source: Journal of Psychopharmacology - September 22, 2016 Category: Psychiatry Authors: Hambly, J. L., Khan, S., McDermott, B., Bor, W., Haywood, A. Tags: Reviews Source Type: research

Macrocytic isolated anaemia as an unusual adverse effect of divalproex sodium in the elderly
Publication date: Available online 10 August 2016 Source:European Geriatric Medicine Author(s): L. Godaert, L.A. Saint-Albin, L. Bousquet, J.-L. Fanon, M. Dramé (Source: European Geriatric Medicine)
Source: European Geriatric Medicine - August 10, 2016 Category: Geriatrics Source Type: research

Systematic Review and Meta-analysis of the Efficacy of Oral Medications Compared with Placebo Treatment in the Management of Postherpetic Neuralgia.
Authors: Salah S, Thomas L, Ram S, Clark GT, Enciso R Abstract AIMS: To conduct a systematic review to determine the efficacy of oral medications for the management of postherpetic neuralgia (PHN). METHODS: Three electronic databases were searched: Cochrane Library (up to 7 July 2015), MEDLINE via PubMed (from 1950 to 7 July 2015), and Web of Science (1864 to 7 July 2015). Studies were limited to double-blind, placebo controlled, randomized controlled trials on oral medications used to treat PHN. Risk of bias was independently assessed in duplicate. RESULTS: A total of 256 abstracts were screened by two ind...
Source: Journal of Orofacial Pain - July 30, 2016 Category: ENT & OMF Tags: J Oral Facial Pain Headache Source Type: research

Drugs for Bipolar Disorder
Date: August 15, 2016 Issue #:  1501Summary:  Bipolar disorder is characterized by intermittent episodes of mania and/or depression. Even with maintenance treatment, recurrences of manic or (more frequently) depressive episodes are common. Some of the drugs and dosages recommended here have not been approved by the FDA for use in bipolar disorder. (Source: The Medical Letter)
Source: The Medical Letter - July 13, 2016 Category: Drugs & Pharmacology Authors: admin Tags: Abilify Antidepressants Antiepileptics Antipsychotics Aripiprazole Asenapine Bipolar disorder Carbamazepine Carbatrol Carbolith cariprazine Depakene Depakote Depression Divalproex sodium Electroconvulsive therapy Epival E Source Type: research

Remission of Psychosis in Treatment-resistant Schizophrenia Following a Seizure: A Case Report
Discussion Improvement in our patient’s mental state was very drastic and very closely temporally associated with the occurrence of the seizure. Clozapine-induced seizures are known to occur, as clozapine decreases the seizure threshold, and the cumulative one-year risk of seizure is about five percent.[4] In our patient, the dose of clozapine was high and there was no other comorbid medical or neurological condition that could explain the seizure, leading us to the conclusion that the seizure was caused by clozapine. ECT has been effective in improving patients on clozapine, and as ECT is based on the mechanism of s...
Source: Innovations in Clinical Neuroscience - June 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Case Report Current Issue ECT Epilepsy Neurology Psychiatry Schizophrenia clozapine electroconvulsive therapy (ECT) seizure Treatment-resistant schizophrenia (TRS) Source Type: research

WITHDRAWN: Anticonvulsant drugs for migraine prophylaxis.
CONCLUSIONS: Anticonvulsants appear to be both effective in reducing migraine frequency and reasonably well tolerated. There is noticeable variation among individual agents, but there are insufficient data to know whether this is due to chance or variation in true efficacy. Acetazolamide, clonazepam, lamotrigine and vigabatrin were not superior to placebo (one trial each). Relatively few robust trials are available for agents other than sodium valproate/divalproex sodium and topiramate; gabapentin in particular needs further evaluation. Trials designed with sufficient power to compare different drugs are also necessary. ...
Source: Cochrane Database of Systematic Reviews - May 26, 2016 Category: Journals (General) Authors: Chronicle EP, Mulleners WM Tags: Cochrane Database Syst Rev Source Type: research

Lithium or Valproate Adjunctive Therapy to Second-generation Antipsychotics and Metabolic Variables in Patients With Schizophrenia or Schizoaffective Disorder
Conclusions: These cross-sectional findings suggest it may be beneficial to monitor insulin sensitivity and body mass index in patients taking lithium or valproate in combination with a second-generation antipsychotic. (Source: Journal of Psychiatric Practice)
Source: Journal of Psychiatric Practice - May 1, 2016 Category: Psychiatry Tags: Articles Source Type: research

Release property study on the novel divalproex sodium enteric-coated capsules
Publication date: Available online 26 April 2016 Source:Saudi Pharmaceutical Journal Author(s): Shuoye Yang, Xin Wang, Jiangsong Jia, Pengyuan Li In present study, a novel divalproex sodium (DS) enteric-coated capsule was prepared, high performance liquid chromatography (HPLC) assay method for DS was developed. Their uniformity, release curve and release characteristics in different solvents were examined. The release studies were performed using marketed sample as a reference and data were analyzed in terms of cumulative release amounts as a function of time. It was demonstrated by the results that assay developed w...
Source: Saudi Pharmaceutical Journal - April 26, 2016 Category: Drugs & Pharmacology Source Type: research

Cerebral Amyloid Angiopathy Presenting as New Onset Refractory Status Epilepticus(NORSE), Complicated by Psychosis, Dysautonomia and Posterior Reversible Encephalopathy Syndrome(PRES) (P6.219)
We present a case of a 74y/o male who presented with refractory status epilepticus without any CMBs at initial presentation,clinical course complicated by Visual hallucinations,dysautonomia and PRES,CAA diagnosed by brain biopsy.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Prasad, A., Sharma, S., Schmidt, E., Latorre, J. Tags: Behavioral and Cognitive Neurology: Clinical Syndromes Source Type: research

Safety and effectiveness of divalproex sodium extended release containing regimen in Indian patients with bipolar I disorder in continuation phase: Results of EASED registry.
Authors: Shah N, Reddy MS, Vohra S, Chaudhuri U, Mohanasundaram S Abstract The study was conducted to evaluate the safety and effectiveness of divalproex sodium XR containing regimen in patients with bipolar disorder (BPD) who are in continuation phase. It was an open-label, prospective, observational study conducted from July 2010 to December 2011 at 48 sites across India. Adult patients with bipolar I disorder of manic or mixed type fulfilling the DSM-IV criteria and who were in the continuation phase were included. Safety (primary outcome) was assessed by incidence of treatment emergent adverse events (AEs). Eff...
Source: Asian Journal of Psychiatry - March 31, 2016 Category: Psychiatry Tags: Asian J Psychiatr Source Type: research

Divalproex sodium leading to sustained significant improvement in tardive dyskinesia in a patient with bipolar disorder.
Authors: Pattanayak RD, Charan D PMID: 26985118 [PubMed] (Source: Indian Journal of Psychiatry)
Source: Indian Journal of Psychiatry - March 19, 2016 Category: Psychiatry Tags: Indian J Psychiatry Source Type: research

Acute and continuation pharmacological treatment of children and adolescents with bipolar disorders; a summary of two previous studies.
We report the results of an acute-phase and continuation-phase study of the pharmacological treatment of children and adolescents with bipolar disorders. The acute phase study, with a duration of 6-8 weeks, aimed at developing effect sizes (ES) for lithium, divalproex sodium, and carbamazepine, in the acute phase treatment of Bipolar I or II children and adolescents during a mixed or manic episode. During the acute-phase of treatment, 42 outpatients with a mean age of 11.4 yr. (20 with Bipolar I Disorder and 22 with Bipolar II Disorder) were randomly assigned to 6-8 weeks of open treatment with either lithium, divalproex s...
Source: Acta Neuropsychiatrica - March 18, 2016 Category: Psychiatry Tags: Acta Neuropsychiatr Source Type: research

The rationale, design, and progress of two novel maintenance treatment studies in pediatric bipolarity.
DISCUSSION: Since the blind has not been broken on either of these clinical trials, conclusions about the maintenance effectiveness of either VPA or Li+ in youths with bipolar disorder type 1 or 2 cannot be made yet. Similarly, it is unclear whether VPA is superior to placebo in genetically high-risk youths with cyclotaxia. The final results of these trials should provide valuable information about the treatment of juvenile bipolar disorders. PMID: 26975273 [PubMed] (Source: Acta Neuropsychiatrica)
Source: Acta Neuropsychiatrica - March 18, 2016 Category: Psychiatry Tags: Acta Neuropsychiatr Source Type: research

The Use of Antiepileptics in Migraine Prophylaxis.
CONCLUSIONS: Available AEDs to prophylactically treat migraine are few but of robust clinical efficacy. Special care needs to be exerted with respect to their side effects. Future research is needed for a better understanding of their mechanisms of action in migraine. Such research has the potential of providing some insight into the pathophysiology of migraine. PMID: 26935348 [PubMed - as supplied by publisher] (Source: Headache)
Source: Headache - March 3, 2016 Category: Neurology Authors: Bagnato F, Good J Tags: Headache Source Type: research

Development of fixed dose combination tablets of aripiprazole plus divalproex sodium and their simultaneous determination using HPLC-UV.
Authors: Ahmed Z, Subhan F, Ahmed S, Abdur Rasheed Q, Ahmed S, Shahid M, Farooq S Abstract A vast majority of psychiatric patients are effectively treated with combination of drugs to improve efficacy and adherence, but due to limited research and development in fixed dose combination (FDC) in psychiatry, these products are not commonly available. The aim of this study is to prepare cost effective FDC tablets containing aripiprazole and divalproex sodium. Two batches of fixed dose combination tablets, FDC1 and FDC2, were successfully prepared using wet granulation technique. Furthermore, aripiprazole tablets A1 and...
Source: Drug Development and Industrial Pharmacy - February 16, 2016 Category: Drugs & Pharmacology Tags: Drug Dev Ind Pharm Source Type: research

Treatment-resistant panic disorder: a systematic review.
Authors: Freire RC, Zugliani MM, Garcia RF, Nardi AE Abstract INTRODUCTION: The prevalence of panic disorder (PD) in the population is high and these patients have work impairment, high unemployment rates, seek medical treatment more frequently and have more hospitalizations than people without panic symptoms. Despite the availability of pharmacological, psychological and combined treatments, approximately one-third of all PD patients have persistent panic attacks and other PD symptoms after treatment. AREAS COVERED: MEDLINE/Pubmed, CENTRAL, PsycINFO and Web of Science databases were searched for clinical trial...
Source: Expert Opinion on Pharmacotherapy - February 14, 2016 Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research

The Use of Antiepileptics in Migraine Prophylaxis
ConclusionsAvailable AEDs to prophylactically treat migraine are few but of robust clinical efficacy. Special care needs to be exerted with respect to their side effects. Future research is needed for a better understanding of their mechanisms of action in migraine. Such research has the potential of providing some insight into the pathophysiology of migraine. (Source: Headache: The Journal of Head and Face Pain)
Source: Headache: The Journal of Head and Face Pain - February 1, 2016 Category: Neurology Authors: Francesca Bagnato, Janine Good Tags: Headache Currents Source Type: research

Heroin Withdrawal: QT Prolongation & Torsade de Pointes
This is the case of a 61 year old male who presented to the emergency department with a chief complaint of nausea and vomiting. The patient was alert and oriented, reporting intermittent chest pressure for the last 12 hours that he rated as a 9/10 pain level. He also reported multiple syncopal episodes within the last 24 hrs. Previous Medical History: Hypertension Previous MI Coronary artery disease 2 coronary stents No known allergies Medications: Lisinopril Plavix Pravachol Depakote Methadone Initial Vital Signs:  Heart  Rate:   72 beats/min  Respiratory Rate: 22 breaths/min  Non-invasive Bl...
Source: EMS 12-Lead - October 29, 2015 Category: Cardiology Authors: Ivan Rios Tags: 12 lead ecg Torsade de Pointes Source Type: research

Treatment of Early-Age Mania: Outcomes for Partial and Nonresponders to Initial Treatment
This report evaluates the benefit of either an add-on or a switch of antimanic medications for an 8-week trial period in partial responders and nonresponders, respectively. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 7, 2015 Category: Psychiatry Authors: John T. Walkup, Karen Dineen Wagner, Leslie Miller, Gayane Yenokyan, Joan L. Luby, Paramjit T. Joshi, David A. Axelson, Adelaide Robb, Jay A. Salpekar, Dwight Wolf, Abanti Sanyal, Boris Birmaher, Benedetto Vitiello, Mark A. Riddle Tags: New research Source Type: research

The Treatment of Early Age Mania: Outcomes for Partial and Non-Responders to Initial Treatment
This report evaluates the benefit of either an add-on or switch of anti-manic medications for an 8-week trial period in partial and non-responders, respectively. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 7, 2015 Category: Psychiatry Authors: John Walkup, Jay A. Salpekar, Paramjit T. Joshi, David A. Axelson, Gayane Yenokyan, Abanti Sanyal, Benedetto Vitiello, Joan Luby, Karen Dineen Wagner, Mark A. Riddle, Leslie Miller, Adelaide Robb, Dwight Wolf, Boris Birmaher Source Type: research

Preventive Migraine Treatment
This article reviews the evidence base for the preventive treatment of migraine. Recent Findings:: Evidence-based guidelines for the preventive treatment of migraine have recently been published by the American Academy of Neurology (AAN) and the Canadian Headache Society (CHS), providing valuable guidance for clinicians. Strong evidence exists to support the use of metoprolol, timolol, propranolol, divalproex sodium, sodium valproate, and topiramate for migraine prevention, according to the AAN. Based on best available evidence, adverse event profile, and expert consensus, topiramate, propranolol, nadolol, metoprolol, amit...
Source: CONTINUUM - August 1, 2015 Category: Neurology Tags: Review Articles Source Type: research

Cross section comparative study for comorbid migraine and major depression in epileptic patients: demographic, clinical, electroencahpalograhy and therapeutic implications
Conclusion: It is important to address comorbidity in treating patients with epilepsy. The diagnosis of atypical migraine symptoms can be quite difficult, in such cases EEG may be useful. Some antiepileptic drugs (AEDs) like divalproex sodium (valproate) and topiramate are effective in preventing migraine attacks, while others including phenytoin, oxcarbazepine, vigabatrin and clonazepam, are not effective in migraine prophylaxis. The antiepileptic drugs most closely associated with depression on initiation of treatment are vigabatrin, phenobarbitone, and topiramate.Further research on the nature and causes of the co-morbi...
Source: Epidemiologic Perspectives and Innovations - July 13, 2015 Category: Epidemiology Authors: Hatem ElmassryNahla NagyNoha SamyMaissa Eid Source Type: research

N,N-Dimethyltryptamine–Induced Psychosis
Conclusions: This case report illustrates an important example of substance-induced psychosis that resolved with antipsychotic treatment in a 42-year-old white man with no past psychiatric history likely attributable to the use of DMT. Given the increasing use of this substance, the emergency department, primary care, and inpatient services are likely to see a significant increase in similar cases. (Source: Clinical Neuropharmacology)
Source: Clinical Neuropharmacology - July 1, 2015 Category: Neurology Tags: Case Reports Source Type: research

The effect of antidepressants and antipsychotics on weight gain in children and adolescents
In conclusion, prescribing of SSRIs and SNRIs may be associated with improvements in weight status in children and adolescents but trials assessing their use in obesity, outside of established psychiatric illness, are limited and still experimental. Youth prescribed antipsychotic medication should be monitored for exaggerated weight gain and in those where obesity is a pre‐existing concern agents other than olanzapine, clozapine and risperidone may be advantageous. (Source: Obesity Reviews)
Source: Obesity Reviews - May 28, 2015 Category: Eating Disorders and Weight Management Authors: J. Reekie, S. P. M. Hosking, C. Prakash, K.‐T. Kao, M. Juonala, M. A. Sabin Tags: Review Article Source Type: research

Three patients needing high doses of valproic Acid to get therapeutic concentrations.
Authors: Jackson J, McCollum B, Ognibene J, Diaz FJ, de Leon J Abstract Valproic acid (VPA) can autoinduce its own metabolism. Cases requiring VPA doses>4000 mg/day to obtain therapeutic plasma concentrations, such as these 3 cases, have never been published. Case 1 received VPA for seizures and schizophrenia and had>50 VPA concentrations in 4 years. A high dose of 5,250 mg/day of VPA concentrate was prescribed for years but this dose led to an intoxication when switched to the enterocoated divalproex sodium formulation, requiring a normal dose of 2000 mg/day. VPA metabolic capacity was s...
Source: Case Reports in Psychiatry - May 23, 2015 Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research

Limbic Encephalitis Exacerbations and Remissions Charted by Microglial PET Scan: A Case Study (P4.104)
CONCLUSIONS: C-11-PK11195 PET imaging can be useful in the diagnosis of limbic encephalitis and for monitoring response to treatment. MALT lymphoma may also be associated with autoimmune or paraneoplastic encephalitis, especially in individuals with other predisposing factors to autoimmune disorders, such as Tourette’s and autoimmune thyroid disease. The reduction in microglial activity with both IVIG and anti-psychotics supports previous findings that anti-psychotics may act through anti-inflammatory pathways.Disclosure: Dr. Shatz has received research support from Janssen Pharmaceutica. Dr. Chugani has nothing to d...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Shatz, R., Chugani, H. Tags: Aging, Dementia, Cognitive, and Behavioral Neurology: Rapidly Progressive and Inflammatory Dementias Source Type: research

Divalproex sodium and quetiapine treatment of a pedophile with bipolar spectrum disorder.
Authors: Wang SC, Kao YC, Liu YP PMID: 25093789 [PubMed - in process] (Source: Journal of Neuropsychiatry and Clinical Neurosciences)
Source: Journal of Neuropsychiatry and Clinical Neurosciences - November 16, 2014 Category: Psychiatry Tags: J Neuropsychiatry Clin Neurosci Source Type: research

Divalproex sodium enhances the anti-leukemic effects of imatinib in chronic myeloid leukemia cells partly through SIRT1
Imatinib (IM) represents a breakthrough in the treatment of chronic myeloid leukemia (CML) by inhibiting the activity of Bcr-Abl tyrosine kinase. However, many patients exhibit resistance to IM in the clinic. Recent studies have indicated that sirtuin 1 (SIRT1), a class III histone deacetylase (HDAC), plays an important role in leukemogenesis. In addition, some HDAC inhibitors are being tested to determine their anti-cancer activities in clinical trials. Divalproex sodium (DVPX), a first-line treatment for epilepsy, is also a HDAC inhibitor. (Source: Cancer Letters)
Source: Cancer Letters - October 31, 2014 Category: Cancer & Oncology Authors: Weirong Wang, Jianfeng Zhang, Yanxiang Li, Xiaofeng Yang, Yanhao He, Tingting Li, Feng Ren, Jiye Zhang, Rong Lin Tags: Original Articles Source Type: research