divalproex sodium XR / Generic mfg. - LARVOL DELTA

Systematic Review of the Effectiveness and Experiences of Treatment for Men With Borderline Personality Disorder. (PubMed, Am J Mens Health) - "Pharmacologic treatment included topiramate, divalproex Extended-Release, and high-dose baclofen. Our findings are limited by inadequate power and heterogeneity of the included studies. Further research with larger sample sizes and qualitative studies is needed to better understand the treatment experience for men with BPD."

Journal • Review • Borderline Personality Disorder • CNS Disorders • Mood Disorders • Personality Disorder

[PREPRINT] Phase 2 Study of Sorafenib, Valproic Acid, and Sildenafil in the Treatment of Recurrent High-Grade Glioma (medRxiv) - P2 | N=47 | NCT01817751 | "Clinical toxicities were Grade 1 and Grade 2, with one Grade 3 toxicity for maculopapular rash (6.4%). For all evaluable patients the median progression free survival (PFS) was 3.65 months and overall survival (OS) 10.0 months. There was promising evidence showing clinical activity and benefit. In the 33 evaluable patients, low protein levels of the chaperone GRP78 (HSPA5) was significantly associated with a better OS (p < 0.0026). A correlation between the expression of PDGFR; and OS approached significance (p < 0.0728). Five patients presently have a mean OS of 73.6 months and remain alive. This is the first therapeutic intervention glioblastoma trial to significantly associate GRP78α expression to overall survival."

P2 data • Preprint • Brain Cancer • CNS Tumor • Glioblastoma • Glioma • Oncology • Solid Tumor

Development and Characterization of Hygroscopicity-Controlled Sustain Release Formulation of Divalproex Sodium. (PubMed, Turk J Pharm Sci) - "FTIR and DSC analysis did not show any significant interaction between DS and components of the solid dispersion. Optimized formulation from this study can be used to manufacture divalproex extended-release tablets inside facilities lacking dehumidifiers."

Journal

Efficacy, Safety, and Retention Rate of Extended-Release Divalproex Versus Conventional Delayed-Release Divalproex: A Meta-Analysis of Controlled Clinical Trials. (PubMed, Front Pharmacol) - "Purpose: A novel once-daily divalproex-extended release (ER) dose formulation has been developed; this formulation prolongs the therapeutic serum levels of the drug, compared with the twice-daily conventional divalproex-delayed release (DR) formulation...In addition, the acceptable medicine compliance of VPA-ER was conducive to the long-term maintenance treatment of chronic diseases. Although we analyzed open labels and crossover design RCTs, large-scale multicenter studies on the efficacy and medicine compliance of new ER formulations with less AEs are required to validate our conclusion."

Clinical • Retrospective data • Review • Bipolar Disorder • CNS Disorders • Epilepsy • Migraine • Mood Disorders • Psychiatry

Efficacy, safety, and retention rate of extended-release divalproex versus conventional delayed-release divalproex: A protocol for systematic review and meta-analysis. (PubMed, Medicine (Baltimore)) - "Once-daily VPA-ER may present a positive efficacy and not increase the incidence of AEs and has a higher retention rate for patients, which can be used as a substitute for conventional VPA-DR.INPLASY registration number: INPLASY2021110090(DOI: 10.37766/inplasy2021.11.0090)."

Journal • Retrospective data • Review

Comparison of Divalproex Sodium Extended-release and Delayed-release Formulations Initiated in Pediatric Patients Who Are Admitted to an Inpatient Psychiatric Unit (ASHP 2021) - No abstract available

Clinical • Pediatrics • Psychiatry

Impact of Valproate on Angiogenesis and Histone Deacetylation in Bladder Cancer (clinicaltrials.gov) - P1; N=43; Completed; Sponsor: State University of New York - Upstate Medical University; Phase classification: P=N/A ➔ P1

Phase classification • Bladder Cancer • Genito-urinary Cancer • Oncology • Solid Tumor • Urothelial Cancer • THBS1

The efficacy and safety of antiepileptics in the prophylaxis of pediatric migraine: the meta-analysis of randomized controlled trials. (PubMed, Transl Pediatr) - "Four RCTs assessed topiramate vs. placebo and 3 RCTs evaluated divalproex sodium extended-release (DVPX ER) vs. placebo. DVPX ER showed no difference from placebo in the prophylactic treatment pediatric migraine. Side effects seemed to be more frequent in topiramate and DVPX ER treated children but generally well-tolerated."

Journal • Retrospective data • CNS Disorders • Epilepsy • Migraine • Pain • Pediatrics

Drug-Drug Interaction Study to Evaluate the Effect of Inhibition of UGTs on the PK of Ecopipam and Its Active Metabolite (clinicaltrials.gov) - P1; N=38; Completed; Sponsor: Emalex Biosciences Inc.; Recruiting ➔ Completed

Clinical • Trial completion

Drug-Drug Interaction Study to Evaluate the Effect of Inhibition of UGTs on the PK of Ecopipam and Its Active Metabolite (clinicaltrials.gov) - P1; N=40; Recruiting; Sponsor: Emalex Biosciences Inc.

Clinical • New P1 trial

13 Drugs That Can Make You Gain Weight (Health.com) - "Paxil is one of the best anxiety treatments, but if you gain weight while using it you could talk with a doctor about switching to a more weight-neutral SSRI such as Prozac or Zoloft, says Louis Aronne, MD...It can be hard to counteract the side effects of long-term steroid use, but exercise, diet, and, in some cases, taking metformin can help, Dr. Aronne says."

Media quote

Drug approval reports (FDA) - Labelling update for Depakote (divalproex sodium) approved on 10th Feb, 2021.

sNDA • CNS Disorders • Epilepsy • Migraine • Pain • Systemic Sclerosis

[VIRTUAL] Addressing Ocular Deficits In Patients With Schizophrenia (ASHP 2020) - "His current medication regimen consists of haloperidol, perphenazine, and benzatropine; during his stay he has been on combinations that included clozapine, quetiapine, olanzapine, risperidone, loxapine, divalproex sodium, and lithium...However, there is a paucity of information on how similar issues in patients with mental disorders such as schizophrenia might be particularly affected. Further studies could shed light on how sensory misperceptions might confound the schizophrenia diagnosis."

Clinical • CNS Disorders • Mental Retardation • Psychiatry • Schizophrenia

[VIRTUAL] Therapeutic drug monitoring of divalproex sodium and valproic acid (ASHP 2020) - "These finding suggest an opportunity for increased therapeutic drug monitoring and safety monitoring for divalproex sodium and valproic acid. While levels >100 mcg/ml did not result in serious side effects in this patient population, further research is warranted to investigate variation in prescriber response to valproic acid levels >100 mcg/ml."

Anesthesia • Hematological Disorders • Hepatology • Liver Failure • Movement Disorders • Psychiatry • Thrombocytopenia

[VIRTUAL] Triple combination therapy (vitamin C, vitamin D3, and zinc) in the treatment of the SARS-CoV-2 infection in a schizoaffective bipolar patient: a case report (ASHP 2020) - "With the patient being a psychiatric patient on divalproex sodium and olanzapine, using the triple combination therapy is safer than using some of the alternative investigational treatment options. Although more studies are needed to solidify the use of the triple combination therapy in psychiatric COVID-19 positive or previously positive patients, its’ use is highly promising per the data obtained from ongoing research."

Clinical • Combination therapy • Acute Respiratory Distress Syndrome • CNS Disorders • Infectious Disease • Novel Coronavirus Disease • Psychiatry • Respiratory Diseases • Schizophrenia • Septic Shock

[VIRTUAL] The first case of autosomal recessive ELOVL1 gene mutation causing infantile spasm (AES 2020) - "She was received two courses of ACTH, then started on Vigabatrin, Topamax and Depakote. The ELOVL4 gene mutation is a rare condition associated with epilepsy. Our case identifies recessive ELOVL4 mutation causing neuro-ichthyotic syndrome with severe infantile epileptic encephalopathy and emphasize the importance of VLCFA in brain and cutaneous development. Funding: None"

Clinical • Age-related Macular Degeneration • Ataxia • Atopic Dermatitis • Atrial Fibrillation • Cardiovascular • CNS Disorders • Dermatology • Dermatopathology • Developmental Disorders • Epilepsy • Immunology • Macular Degeneration • Movement Disorders • Ocular Inflammation • Ophthalmology • Vitiligo • MRI

[VIRTUAL] Corpus Callosotomy and Intracranial Electroencephalogram: Multi-Staged Diagnostic Procedure for Epileptogenic Focus Lateralization and Localization in Medically Refractory Focal Epilepsy Syndrome for Epilepsy Surgery (AES 2020) - "Lamotrigine was avoided. Phenytoin, oxcarbazepine, levetiracetam, and lacosamide were ineffective. He was maintained on divalproex sodium, topiramate, and clorazepate... CC is a palliative procedure for medically refractory generalized epilepsy syndromes. While CC has no therapeutic benefit in focal epilepsy syndromes, it has emerged with diagnostic value. Only a few studies have discussed the role of CC and iEEG, as a multi-staged diagnostic procedure for the lateralization and localization of an epileptogenic focus prior to epilepsy surgery."

CNS Disorders • Epilepsy • Steven-Johnson Syndrome • MRI

"PLEASE bring back divalproex sodium ER, the made in India stuff is TERRIBLE!!" (@vikvargar)

Therapeutic drug monitoring of valproic acid in extracorporeal membrane oxygenation. (PubMed, Perfusion) - "VPA may be an effective anti-seizure medication in ECMO patients. Free VPA levels should be more readily available to better quantify efficacy or toxicity, especially in ECMO patients."

Journal • Cardiovascular • CNS Disorders • Epilepsy • Movement Disorders • Respiratory Diseases

"@abbvie @GSKUS - Abbvie, although pricey, does offer a nice discount program but GSK , unless you meet poverty levels, does not. Cost for Depakote brand out of pocket - about $ 450. a month. Lamictal Brand out of pocket currently running at $1,450. a month." (@barbward804)

Pricing

Valproate Alone or in Combination With Quetiapine for Severe COVID-19 Pneumonia With Agitated Delirium (clinicaltrials.gov) - P4; N=20; Not yet recruiting; Sponsor: University of Miami; Trial completion date: Nov 2021 ➔ Nov 2022; Initiation date: Nov 2020 ➔ Nov 2021; Trial primary completion date: Nov 2021 ➔ Nov 2022

Clinical • Combination therapy • Trial completion date • Trial initiation date • Trial primary completion date • CNS Disorders • Infectious Disease • Novel Coronavirus Disease • Pneumonia • Respiratory Diseases

"@CAgovernor @MedBoardOfCA @FDA_Drug_Info @NIH_NIAMS @AmerMedicalAssn @ABC7 @PoliteVirginia #medications Tues Oct 20, 2020 3:43 A.M PST. Riverside County, CA has a medication distribution & quality problem in available medications for the poor, 1. Kaletra 2. Truvada 3. Depakote" (@NuneVajrapani)

"Interesting about the benadryl. Thoughts on depakote as an add on?" (@gdawod1)

"Sure Depakote, IV steroids, haloperidol are all reasonable options!" (@sauravmed)

Palato-pharyngo-laryngeal myoclonus with recurrent retrograde feeding tube migration after cerebellar hemorrhagic stroke: a case report and review of hypertrophic olivary degeneration. (PubMed, BMC Neurol) - "This case study indicates that the movement disorder associated with hypertrophic olivary degeneration may involve the gastrointestinal system. Anticonvulsants, such as gabapentin and divalproex sodium, may reduce the severity of gastrointestinal symptoms in cases associated with hypertrophic olivary degeneration. The anatomy of the Guillain-Mollaret triangle and the pathophysiology of hypertrophic olivary degeneration are reviewed."

Clinical • Journal • Cardiovascular • Cerebral Hemorrhage • Gastrointestinal Disorder • Hematological Disorders • Movement Disorders