Valproate, sodium

Martin, M.L. Regan, C.M. (1988). The anticonvulsant sodium valproate specifically induces the expression of a rat glial heat shock protein which is identified as the collagen type IV receptor. Brain Res. 459, 131-137. 

The evidence base for clinical decisions based on cost-effectiveness for the affective disorders is less clear than for schizophrenia. In bipolar disorder the primary effectiveness of the mainstay treatments, lithium and anticonvulsant pharmacotherapy, is undergoing considerable revision (Bowden et al, 2000). Until this is clarified, cost-effectiveness studies are probably premature. Nevertheless the cost burden in bipolar disorder is qualitatively similar to that in schizophrenia, with in-patient costs being the primary burden and associated social costs in treated patients. The drug costs are even less than those for schizophrenia. In Chapter 5 John Cookson suggests there is little economic evidence to drive prescribing decisions. The in-patient burden does not seem to have altered with the introduction of lithium. The only drug-related study (Keck et al, 1996) showed an obvious difference in treatment costs only when lithium was compared with sodium valproate. Since these are both cheap drugs this is unlikely to influence clinical decisions. The main question is what impact... 

Sodium valproate GM PM 6 also 1 Inhibition of GABA metabolism... 

Valproate Sodium Valproate sodium is an older AED that was released as an intravenous preparation (Depacon ) in 1996. Although it is not FDA-approved for SE, its use has been documented in various types of SE including generalized tonic-clonic, myoclonic, and non-convulsive SE.22,23 Reports indicate... 

Goal Seizure control Sodium valproate 30 mg/kg 66% 4%/0% valproate controlled... 

Misra UK, Kalita J, Patel R. Sodium valproate vs phenytoin in status epilepticus A pilot study. Neurology 2006 67 340-342. 

Benzodiazepines are the evidence-based treatment of choice for uncomplicated alcohol withdrawal.17 Barbiturates are not recommended because of their low therapeutic index due to respiratory depression. Some of the anticonvulsants have also been used to treat uncomplicated withdrawal (particularly car-bamazepine and sodium valproate). Although anticonvulsants provide an alternative to benzodiazepines, they are not as well studied and are less commonly used. The most commonly employed benzodiazepines are chlordiazepoxide, diazepam, lorazepam, and oxazepam. They differ in three major ways (1) their pharmacokinetic properties, (2) the available routes for their administration, and (3) the rapidity of their onset of action due to the rate of gastrointestinal absorption and rate of crossing the blood-brain barrier. 

Divalproex sodium is comprised of sodium valproate and valproic acid. The delayed-release and extended-release formulations are converted in the small intestine into valproic add, which is the systemically absorbed form. It was developed as an antiepileptic drug, but also has efficacy for mood stabilization and migraine headaches. It is FDA-approved for the treatment of the manic phase of bipolar disorder. It is generally equal in efficacy to lithium and some other drugs for bipolar mania. It has particular utility in bipolar disorder patients with rapid cycling, mixed mood features, and substance abuse comorbidity. Although not FDA-approved for relapse prevention, studies support this use, and it is widely prescribed for maintenance therapy. Divalproex can be used as monotherapy or in combination with lithium or an antipsychotic drug.31... 

Sodium valproate Inhibits GABA 600-1200 mg/day Neurologic disturbances, Variable efficacy seen in Cushing s... 

Introduced in clinical practice in the 1960s, lithium was the first mood stabilizer to be used in China. This was followed by carbamazepine and sodium valproate. For many years, these were the only treatment options available as mood stabilizers. Although lamotrigine was approved for maintenance treatment of bipolar I disorder in 2003 by FDA (Food and Drug Administration) in the USA, this indication has not yet been approved by the Chinese authorities. At present, only one atypical antipsychotic drug, risperidone, has been approved for treating acute mania (February 2005 by SFDA [State Food and Drug Administration]) in China (see Table 6.1). 

Valproic Acid and Sodium Valproate Comprehensive Profile... 

Valproic acid 2-Propylvaleric acid 2-Propylpentanoic acid di-w-Propylacetic acid Sodium valproate Sodium 2-propylvalerate Sodium 2-propylpentanoate Sodium di-w-propylacetic acid Sodium di-w-propylacetate... 

Nonproprietary names Valproic acid, Sodium valproate... 

Valproic acid Abbott-44089 Sodium valproate Abbott-44090... 

Sodium valproate is a white or almost white, hygroscopic, crystalline, and deliquescent powder. 

The USP solutions of valproic acid and sodium valproate, which are prepared with the aid of sodium hydroxide, have a pH of 7-8 [3]. 

Sodium valproate is very soluble in water, slight to freely soluble in alcohol [2,3]. 

Valproic acid and sodium valproate have no optical activity. 

Sodium valproate does not melt, decompose, or physically change in the normal working range of the Thomas Hoover capillary melting point apparatus [5]. Valproic acid boils at 120-121 °C [2]. 

Table 1. Crystallographic data from the X-ray powder diffraction pattern of sodium valproate...

Sample Sodium valproate File C ... volume-32Walproic Val0 4.001... 

Fig. 2. Differential scanning calorimetry thermogram of sodium valproate.

The infrared absorption spectrum of sodium valproate and valproic acid were obtained in a KBr disc using a Perkin-Elmer infrared spectrophotometer. The infrared spectra of sodium valproate and valproic acid are shown in Figs. 4A and... 

Fig. 3. The ultraviolet absorption spectrum of sodium valproate in water.

B, respectively. The infrared absorption bands assignments for sodium valproate and valproic acids are shown in Table 2(A) and (B), respectively. 

Fig. 4. (A) The infrared absorption spectrum of sodium valproate obtained in a KBr pellet. (B) The infrared absorption spectrum of valproic acid obtained in a KBr pellet.

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