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Emili Leary, Raj D Sheth, Barry E Gidal
PURPOSE: Conversion to lamotrigine (LTG) monotherapy from sodium valproate (VPA) is complicated by the robust pharmacokinetic interaction between the two AEDs. This study examined changes in LTG serum concentrations immediately following VPA discontinuation. METHODS: Ten healthy female and male adult subjects were initiated on LTG (Lamictal) 10 mg orally every morning for 30 days and VPA (Depakote ER) 500 mg orally every morning for 14 days. Morning trough (pre-dose) venous blood samples were obtained for determination of LTG and VPA concentrations on study days 14, 15, 16, 18, 20, 22, 24, 26, 28, and 30...
April 2018: Seizure: the Journal of the British Epilepsy Association
Brenda Vincenzi, Claire M Greene, Melissa Ulloa, Lindsey Parnarouskis, John W Jackson, David C Henderson
OBJECTIVE: People with schizophrenia are at greater risk for cardiovascular disease and their overall mortality rate is elevated compared to the general population. The metabolic side effects of antipsychotic medications have been widely studied; however, the effect of adding conventional mood stabilizers, such as lithium and valproate, to antipsychotic medication has not been assessed in terms of metabolic risk. The primary purpose of this secondary analysis was to examine whether treatment with lithium or valproate in addition to a second-generation antipsychotic is associated with poorer metabolic outcomes than treatment with a second-generation antipsychotic without lithium or depakote...
May 2016: Journal of Psychiatric Practice
Neil E Paterson, W Connor Darby, Preetpal S Sandhu
BACKGROUND: N,N-dimethyltryptamine (DMT) is a 5-hydroxytryptamine 2A and 1A receptor agonist that exhibits potent psychoactive properties in humans. Recreational use of this drug has increased precipitously and is likely to result in an increase in patients presenting with substance-induced psychoses. The present case provides an early example of substance-induced psychosis attributable to repeated use of DMT. CASE: A 42-year-old white man, with no significant past psychiatric history, was brought to the emergency department by the police and was found to exhibit disinhibited behavior, elevated affect, disorganized thought process, and delusions of reference...
July 2015: Clinical Neuropharmacology
Cynthia Kenmuir, Mark Richardson, Gena Ghearing
RATIONALE: Medication resistant temporal lobe epilepsy occurs in a small population of patients with fragile X syndrome. We present the case of a 24-year-old man with medically refractory temporal lobe epilepsy and fragile X syndrome who underwent left anterior temporal lobectomy resulting in cessation of seizures. METHODS: Our patient was diagnosed with fragile X syndrome with a fully mutated, fully methylated FMR1 gene resulting in 572 CGG repeats. He developed seizures initially controlled with Depakote monotherapy, but progressed to become medically refractive to combination treatment with Depakote, lamotrigine and zonisamide...
October 2015: Brain & Development
Niranjan N Singh, Pradeep Sahota
Sleep and headache have both generated curiosity within the human mind for centuries. The relationship between headache and sleep disorders is very complex. While Lieving in 1873 first observed that headaches were linked to sleep, Dexter and Weitzman in 1970 described the relationship between headache and sleep stages. Though our understanding of sleep and headache relationship has improved over the years with expanding knowledge in both fields and assessment tools such as polysomnography, it is still poorly understood...
December 2013: Current Treatment Options in Neurology
Volney L Sheen, Maithreyi Shankar, Isaac Marin-Valencia, Carolyn H Bridgemohan, Alcy R Torres
Attention-deficit/hyperactivity disorder is the most common neurobehavioral disorder in children and frequently associated with epilepsy. For patients with both conditions, methylphenidate remains a mainstay in the treatment of behavioral problems. Most studies demonstrate that methylphenidate is effective in treating children with well-controlled epilepsy, and that methylphenidate does not increase the risk of having seizures in patients with EEG abnormalities without epilepsy. However, in patients with active seizures, the results are somewhat contradictory...
July 2013: Pediatric Neurology
Madiha Raina, Gisela Chelimsky, Thomas Chelimsky
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...
October 2013: Clinical Pediatrics
Kamini Vasudev, Anna Mead, Karine Macritchie, Allan H Young
PURPOSE: This audit was conducted on acute psychiatric in-patient wards with the aim of establishing if valproate prescribing in acute mania followed evidence-based guidelines with particular emphasis on formulations used and whether accelerated valproate dosing was employed. DESIGN/METHODOLOGY/APPROACH: Case notes from 43 (42 percent male) patients admitted with mania and subsequently discharged on valproate were reviewed. Valproate formulation, weight measurement (necessary for dose-calculation in accelerated dosing), initial valproate dose and increments, serum valproate monitoring and other prescribed psychotropic agents were noted...
2012: International Journal of Health Care Quality Assurance
Yong Tang, Adly Yacoub, Hossein A Hamed, Andrew Poklepovic, Gary Tye, Steven Grant, Paul Dent
The present studies were designed to determine whether the multi-kinase inhibitor sorafenib (Nexavar) interacted with histone deacetylase inhibitors to kill glioblastoma and medulloblastoma cells. In a dose-dependent fashion sorafenib lethality was enhanced in multiple genetically disparate primary human glioblastoma isolates by the HDAC inhibitor sodium valproate (Depakote). Drug exposure reduced phosphorylation of p70 S6K and of mTOR. Similar data to that with valproate were also obtained using the HDAC inhibitor vorinostat (Zolinza)...
May 2012: Cancer Biology & Therapy
Fade Mahmoud, Rajesh R Tampi
BACKGROUND: Valproic acid (VPA) is commonly used to treat many psychiatric conditions in the elderly. VPA-induced parkinsonism is a less common but important adverse effect of this drug. OBJECTIVES: The purpose of our study was to conduct a literature review to assess VPA-induced parkinsonism in the elderly. METHODS: We searched Ovid Medline, PubMed, and Cochrane Database (January 1970 to December 2010) using the key words divalproate, divalproex sodium, valproate, depakote, valproic acid, elderly, aged, Parkinson's disease, and parkinsonism...
December 2011: American Journal of Geriatric Pharmacotherapy
Khadija H Chaudrey, Tarik B Naser, Ashley Steinberg, Kuntal D Avashia, Mehdi Nouri-Kolouri, Sara Asadi, Shumaila I Irshad Khan, Muhammad Ihsan
Depakote-induced hepatotoxicity has been well established as an adverse effect, and periodic monitoring of drug level is often required. Depakote-induced hepatotoxicity mostly occurs at supratherapeutic drug level. Rarely, an idiosyncratic response is triggered, and hepatotoxicity can occur at the therapeutic drug level mostly in chronic users. Here, we describe a rare case of idiosyncratic depakote-induced hepatotoxicity. A 25-year-old female with non-insulin-dependent diabetes mellitus, hypothyroidism, seizure disorder, and Dandy Walker Syndrome presented with an unwitnessed seizure and altered mental status...
November 2012: American Journal of Therapeutics
Kevin A David, Nigel P Mongan, Christopher Smith, Lorraine J Gudas, David M Nanus
Retinoic acid derivatives have shown their greatest benefit in acute promyelocytic leukemia, but have also demonstrated pre-clinical anti-cancer effects in some solid tumors. Histone deacetylase inhibitors, by upregulating gene expression, are able to limit cancer cell proliferation and induce apoptosis. The combination of all-trans retinoic acid (ATRA) and the histone deacetylase inhibitor valproic acid has been previously studied in hematologic malignancies. We conducted a phase I two-step dose escalation trial of the liposomal ATRA analog ATRA-IV and divalproex sodium (Depakote) in nine patients with advanced solid tumors refractory to prior therapy...
May 1, 2010: Cancer Biology & Therapy
Nancie M Archin, Manzoor Cheema, Daniel Parker, Ann Wiegand, Ronald J Bosch, John M Coffin, Joseph Eron, Myron Cohen, David M Margolis
BACKGROUND: Human immunodeficiency virus (HIV) infection that persists despite antiretroviral therapy (ART) is a daunting problem. Given the limited evidence that resting CD4+ T cell infection (RCI) is affected by the histone deacetylase (HDAC) inhibitor valproic acid (VPA), we measured the stability of RCI and residual viremia in patients who added VPA with or without raltegravir (RAL), or enfuvirtide (ENF) with or without VPA, to standard ART. METHODS: Patients with plasma HIV RNA<50 c/mL added sustained-release VPA (Depakote ER) twice daily, RAL 400 mg twice daily, or ENF 90 mcg twice daily...
February 23, 2010: PloS One
Stephen I Deutsch, Jessica A Burket, Richard B Rosse
A patient with valproate-induced hyperammonemic encephalopathy presented with altered mental status and hyperammonemia in the context of normal liver functions. Fortunately, altered mental status and elevated plasma ammonia level normalized 1 day after discontinuation of divalproex sodium (Depakote). The case analysis suggests a possible synergistic interaction of valproic acid and topiramate with respect to the emergence of hyperammonemic encephalopathy in the context of normal liver functions. Possible mechanisms of the encephalopathy and hyperammonemia are discussed...
November 2009: Clinical Neuropharmacology
Dennis A Revicki
Bipolar disorder is a chronic and severe affective disorder which has a significant impact on patient functioning and well-being, and on total medical costs. Divalproex sodium (Depakote) has been shown to be effective in treating acute mania and for the long-term treatment of bipolar disorder. Few health-related quality of life or pharmacoeconomic studies have been completed comparing divalproex sodium with other mood stabilizers. Clinical trials have demonstrated that the response to divalproex sodium therapy is associated with improvements in health-related quality of life outcomes and reduced disability days...
February 2004: Expert Review of Pharmacoeconomics & Outcomes Research
S Chakraborty, J K Pandit, A Srinatha
Bilayered tablets of Divalproex sodium for once-a-day administration were prepared using a hydrophilic and hydrophobic polymer as release retarding agents. This technology was found to be more effective than a simple matrix tablet with a mixture of the above polymers in order to retard the drug release for a period of 24 h. The drug release profile was strongly dependent on the presence of wicking agent, pathlength of hydrophobic layer, and hardness of tablet. f(1) value of 6.92 and f(2) value of 76.72 indicated similarity between the release profiles of batch BT3 and reference tablet (Depakote((R)) ER) with the target release of over 55% within 12 h and over 85% within 18 h...
July 2009: Current Drug Delivery
Prachi Joshi, Rahil Kasmani, Jocelyn Hollingsworth, Karl Fernandes, Kewal Mahajan
Eosinophilic pleural effusion is defined as an effusion in which eosinophils constitute more than 10% of white blood cells. These effusions can be due to multiple causes with drugs being implicated as one of the etiological agents. We report a case of 48-year-old woman with seizure disorder on divalproex sodium (Depakote) who presented with dyspnea. A chest radiograph demonstrated right pleural effusion. Investigations showed peripheral blood eosinophilia with thoracocentesis revealing eosinophilic exudative pleural effusion...
November 2009: American Journal of Therapeutics
Laura Redden, Melissa DelBello, Karen Dineen Wagner, Timothy E Wilens, Shishuka Malhotra, Patricia Wozniak, Namita V Vigna, Nicholas Greco, Xenia Kovacs, Walid Abi-Saab, Mario Saltarelli
OBJECTIVE: The objective of this open-label study was to assess the safety of divalproex sodium extended-release in the treatment of children and adolescents with acute mania associated with bipolar I disorder. METHODS: This was a 6-month, Phase 3, open-label study in healthy subjects aged 9-17 years with a current Diagnostic and Statistical Manual of Mental Disorders, 4(th) edition, Text Revision (DSM-IV-TR) diagnosis of bipolar I disorder manic or mixed episode...
February 2009: Journal of Child and Adolescent Psychopharmacology
David P Gavin, Saritha Kartan, Kayla Chase, Sundararajan Jayaraman, Rajiv P Sharma
OBJECTIVE: The emerging field of psychiatric epigenetics is constrained by the dearth of research methods feasible in living patients. With this focus, we report on two separate approaches, one in vitro and one in vivo, developed in our laboratory. METHOD: In the first approach, we isolated lymphocytes from 12 subjects and cultured their cells with either 0.7 mM valproic acid (VPA), 100 nM Trichostatin A (TSA), or DMSO (control) for 24h based upon previous dose response experiments...
June 2009: Journal of Psychiatric Research
Nancy M Archin, Joseph J Eron, Sarah Palmer, Anne Hartmann-Duff, Jeffery A Martinson, Ann Wiegand, Nicholas Bandarenko, John L Schmitz, Ronald J Bosch, Alan L Landay, John M Coffin, David M Margolis
OBJECTIVES: Valproic acid and intensified antiretroviral therapy may deplete resting CD4+ T-cell HIV infection. We tested the ability of valproic acid to deplete resting CD4+ T-cell infection in patients receiving standard antiretroviral therapy. METHODS: Resting CD4+ T-cell infection was measured in 11 stably aviremic volunteers twice prior to, and twice after Depakote ER 1000 mg was added to standard antiretroviral therapy. Resting CD4+ T-cell infection frequency was measured by outgrowth assay...
June 19, 2008: AIDS
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