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

Atypical Antipsychotic Utilization in Dementia Patients at a Long-Term Care Facility: A Retrospective Study (P3.206)
CONCLUSIONS: Atypical antipsychotics used in low doses for psychotic related behaviors were highly effective and well tolerated in this population. Despite black-box warnings, antipsychotics should not be discouraged in this setting. Further prospective study is urged.Disclosure: Dr. Scharre has received personal compensation for activities with Forest Laboratories Inc. for speaking, and with Eli Lilly & Co. as a consultant. Dr. Scharre has received research support from Pfizer Inc., Janssen Alzheimer Immunotherapy, Bristol Myers Squibb Co., Phylogeny, and the Mangurian Foundation. Dr. Chang has received research suppo...
Source: Neurology - April 9, 2014 Category: Neurology Authors: Scharre, D., Chang, S.-I., Nagaraja, H., Merjanian, M., Greenley, G., Davis, R. Tags: Aging, Dementia, and Cognitive and Behavioral Neurology: Clinical Aspects Source Type: research

Efficacy and mechanism of anticonvulsant drugs in migraine.
Abstract Anticonvulsants represent one of the main substance classes used for the preventive treatment of migraine. Efficacy has been demonstrated in randomized placebo-controlled trials for topiramate and valproic acid including divalproex sodium. In the case of topiramate, efficacy has recently been proven for chronic migraine and even medication overuse headache, questioning the established concept of medication withdrawal. However, preventive treatment with anticonvulsants is frequently hampered by side effects that occasionally require treatment discontinuation. In addition, these data indicate that some anti...
Source: Pharmacological Reviews - February 5, 2014 Category: Drugs & Pharmacology Authors: Hoffmann J, Akerman S, Goadsby PJ Tags: Expert Rev Clin Pharmacol Source Type: research

Intravenous Dihydroergotamine Therapy for Pediatric Abdominal Migraines
Abdominal migraines present with debilitating symptoms in adolescence. At our institution, the gastroenterology, neurology, and autonomic departments collaborated in treating patients with such presentations. This case series describes 6 patients who were given intravenous dihydroergotamine (DHE) for presumed abdominal migraines. DHE was only used when other agents like amitriptyline, verapamil, topiramate, or depakote had proved ineffective. DHE was started at 0.5 mg dose and on average 7 to 9 mg were given on each hospitalization. Patient ages ranged from 13 to 19 years with the majority being female. One patient did not...
Source: Clinical Pediatrics - September 10, 2013 Category: Pediatrics Authors: Raina, M., Chelimsky, G., Chelimsky, T. Tags: Articles Source Type: research

Fatal heat stroke associated with topiramate therapy
A 40-year-old man with diabetes and seizure disorder was found at home unresponsive and “very hot to touch” by his father 40 minutes before emergency medical services arrival. His usual medications included topiramate, divalproex sodium, and rosiglitazone/metformin. Paramedics administered oxygen, intravenous fluids, and naloxone. They did not witness or report seizure activity. Upon emergency department arrival, the patient was unresponsive (Glasgow Coma Scale 3), hypotensive (94/50 mm Hg), and tachypneic (32 breaths per minute), with a heart rate of 60 beats per minute and elevated rectal temperature peaking ...
Source: The American Journal of Emergency Medicine - September 3, 2013 Category: Emergency Medicine Authors: Stephen W Borron, Robert Woolard, Susan Watts Tags: Case Reports Source Type: research

Methylphenidate and Continuous Spike and Wave During Sleep in a Child With Attention Deficit Hyperactivity Disorder
This article presents the case of a young girl with attention-deficit/hyperactivity disorder and behavioral problems on Depakote (valproic acid) who had an abnormal EEG with left centroparietal spikes but no history of electrographic seizures. She experienced a convulsion the day after her first dose of methylphenidate, and repeat EEG demonstrated continuous spike and slow wave during sleep. This case report suggests that children with continuous spike and slow wave during sleep may have a higher risk of developing seizures with methylphenidate treatment. (Source: Pediatric Neurology)
Source: Pediatric Neurology - July 1, 2013 Category: Neurology Authors: Volney L. Sheen, Maithreyi Shankar, Isaac Marin-Valencia, Carolyn H. Bridgemohan, Alcy R. Torres Tags: Clinical Observations Source Type: research

Valproate (valproic acid or sodium valproate or a combination of the two) for the prophylaxis of episodic migraine in adults.
CONCLUSIONS: Valproate is effective in reducing headache frequency and is reasonably well tolerated in adult patients with episodic migraine. PMID: 23797677 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - June 24, 2013 Category: Journals (General) Authors: Linde M, Mulleners WM, Chronicle EP, McCrory DC Tags: Cochrane Database Syst Rev Source Type: research

Valproate and Lamotrigine in Pediatric Patients With Refractory Epilepsy: After the First Year
This study aims to evaluate the pharmacologic properties of using this combination in a pediatric population refractory to antiepileptic drugs, with an extended follow-up. We studied a group of 51 patients, ranging from 4 to 16 years of age. Sixteen patients (31.4%) had generalized epilepsy and 35 (69.6%) had focal epilepsy. The combination was effective in 39 patients (76.5%) in the first year of follow-up and in 36 patients (70.6%) in the second year, with a reduction in drop attacks observed in 22 (88.5%). Adverse effects included rash, leading to discontinuation in four patients (7.8%). Slower introduction of lamotrigi...
Source: Pediatric Neurology - May 15, 2013 Category: Neurology Authors: Sigride Thome-Souza, Kette D. Valente Tags: Original Articles Source Type: research

Differential Diagnosis of Psychosis in a Deaf Inpatient with Language Dysfluency.
Authors: Weiler C, Landsberger SA, Diaz DR Abstract This case report demonstrates challenges diagnosing psychosis in language dysfluent deaf patients. Treatment of a 34-year-old deaf man on an inpatient psychiatric unit is described. He had a history of physical aggression and possible symptoms of paranoia and thought disorganization, in addition to learning difficulties and minimal language skills. The patient was placed on a combined hearing/deaf inpatient unit, received specialized programming for deaf patients and was prescribed risperidone and divalproex sodium to treat his aggressive behavior and possible psy...
Source: Clinical Schizophrenia and Related Psychoses - March 30, 2013 Category: Psychiatry Tags: Clin Schizophr Relat Psychoses Source Type: research

Drug rash with eosinophilia and systemic symptoms syndrome associated with use of phenytoin, divalproex sodium, and phenobarbital.
CONCLUSION: After receiving phenytoin for treatment of seizure disorder, a 36-year-old woman developed a fever and maculopapular rash with erythema. This reaction continued even after drug therapy was switched to extended-release divalproex and then phenobarbital. The patient's liver function deteriorated despite discontinuation of all seizure medications. PMID: 23456403 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)
Source: American Journal of Health-System Pharmacy : AJHP - March 15, 2013 Category: Drugs & Pharmacology Authors: Brizendine CE, Naik PJ Tags: Am J Health Syst Pharm Source Type: research

Antidepressant-induced mania in obsessive compulsive disorder.
We present a 48-year-old patient with OCD, on antidepressants, initially for OCD and later for depression as well. She switched to mania after 20 years of treatment, which responded to olanzapine and divalproex sodium. PMID: 22988331 [PubMed] (Source: Indian Journal of Psychiatry)
Source: Indian Journal of Psychiatry - March 9, 2013 Category: Psychiatry Tags: Indian J Psychiatry Source Type: research

Near real‐time adverse drug reaction surveillance within population‐based health networks: methodology considerations for data accrual
ConclusionsNear real‐time sequential safety surveillance is feasible, but several barriers warrant attention. Data quality review of each data extract was necessary. Although signal detection was not affected by delay in analysis, when using a historical control group differential accrual between exposure and outcomes may theoretically bias near real‐time risk estimates towards the null, causing failure to detect a signal. Copyright © 2013 John Wiley & Sons, Ltd. (Source: Pharmacoepidemiology and Drug Safety)
Source: Pharmacoepidemiology and Drug Safety - February 1, 2013 Category: Drugs & Pharmacology Authors: Taliser R. Avery, Martin Kulldorff, Yury Vilk, Lingling Li, T. Craig Cheetham, Sascha Dublin, Robert L. Davis, Liyan Liu, Lisa Herrinton, Jeffrey S. Brown Tags: Original Report Source Type: research