Abstract
Divalproex sodium is an effective anticonvulsant, antimanic, and migraine prophylaxis agent. Recently, a new extended-release (ER) formulation of divalproex sodium has become available, which allows for once-daily dosing and provides prolonged therapeutic serum levels. Using data pooled from nine open-label trials involving 321 epilepsy and psychiatry patients, we compared the efficacy and tolerability of divalproex ER with preceding treatment with the older delayed-release (DR) formulation, based on patient reports and analysis by McNemar's test for within-subject paired data. Divalproex ER was associated with superior tolerability with less frequent tremor, weight gain, and gastrointestinal complaints (all P<0.001), but not less hair loss. Divalproex ER also yielded improved seizure control and greater improvement of psychiatric symptoms, and was greatly preferred by patients over divalproex DR. Although the results of the current analyses must be considered highly tentative due to the open-label nature of the trials included, the findings do suggest broad clinical superiority of the new ER preparation.
References
Mar 1, 1995·Archives of Neurology·N T MathewR L Deaton
Dec 1, 1994·The American Journal of Psychiatry
Mar 23, 1994·JAMA : the Journal of the American Medical Association·C L BowdenJ G Small
Jan 1, 1994·Archives of General Psychiatry·R C KesslerK S Kendler
Jan 1, 1997·Neurology·A BeydounV Shu
May 20, 1999·The New England Journal of Medicine·O Devinsky
May 12, 2000·Archives of General Psychiatry·C L BowdenP J Wozniak
Mar 16, 2001·Expert Opinion on Pharmacotherapy·J W Wheless, V Venkataraman
Jun 12, 2002·Neurology·Frederick G FreitagUNKNOWN Depakote ER Migraine Study Group
Mar 18, 2003·Journal of Clinical Psychopharmacology·Robert Lynn Horne, Cedric Cunanan
Jul 2, 2003·The American Journal of Psychiatry·Franca CentorrinoRoss J Baldessarini
May 31, 2007·Clinical Drug Investigation·Kenneth W SommervilleBasim Uthman
Citations
May 16, 2013·CNS Drugs·Athanasios Gaitatzis, Josemir W Sander
Jun 28, 2008·Journal of Psychopharmacology·C K MartinS R Smith
Jun 22, 2012·PloS One·Robert DentGeorge Wells
Mar 20, 2010·Expert Opinion on Drug Metabolism & Toxicology·Brigitte V Lovell, Michael J Marmura
Jul 20, 2007·Current Medical Research and Opinion·Glen T SchumockJoyce A Cramer
May 28, 2014·Epilepsia·Annie M ClarkJames C Cloyd
Feb 3, 2009·Clinical Neurology and Neurosurgery·Serge J C Pierre-LouisArthur T Evans
Dec 13, 2006·Epilepsy Research·Meir BialerTorbjörn Tomson
Mar 27, 2007·Pharmacotherapy·Lisa M TaylorRobert J Kuhn
Nov 30, 2012·Epilepsia·Ilo E Leppik, Collin A Hovinga
Sep 14, 2010·Journal of Clinical Pharmacy and Therapeutics·R C ReedY Qiu
May 9, 2006·Epilepsy & Behavior : E&B·Paul H McCabeErik B Lehman
Feb 14, 2006·Epilepsy & Behavior : E&B·Ronald C ReedG Richard Granneman
Jun 19, 2015·Current Psychiatry Reports·Andrea MurruEduard Vieta
Nov 7, 2009·Epilepsy Research·Ronald Charles ReedWei Liu
Nov 26, 2010·Seizure : the Journal of the British Epilepsy Association·S DedeurwaerdereT J O'Brien
Sep 11, 2014·Epilepsy Research·Patsy RameyBassel Abou-Khalil
May 11, 2016·The International Journal of Neuroscience·Sherifa A Hamed, Mostafa M Abdellah
Mar 30, 2006·The Annals of Pharmacotherapy·Sandeep DuttaRobert F O'Dea
Mar 5, 2009·Journal of Child Neurology·Cynthia SharpeDoris A Trauner
Jul 11, 2007·Journal of Child Neurology·Alberto VerrottiFrancesco Chiarelli
Jun 17, 2006·Therapeutic Drug Monitoring·Ronald C Reed, Sandeep Dutta
Mar 29, 2019·Continuum : Lifelong Learning in Neurology·Bassel W Abou-Khalil
Aug 31, 2012·Journal of Neurology, Neurosurgery, and Psychiatry·Eugen TrinkaUNKNOWN KOMET Study Group
Nov 30, 2018·Expert Opinion on Pharmacotherapy·Monika BanachStanisław J Czuczwar