The Use of the Extended Release Formulation of Divalproex Sodium in Patients with Epilepsy
Abstract number :
1.291
Submission category :
Year :
2001
Submission ID :
404
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
D. Zielinski, RN, MS, ANPC, Neurology, Rush Medical College, Chicago, IL; M.C. Smith, M.D., Neurology, Rush Medical College, Chicago, IL
RATIONALE: The purpose of this review is to evaluate the tolerability and efficacy of the extended release formulation of divalproex sodium following a switch from the standard formulation. Divalproex sodium is an effective broad-spectrum anticonvulsant commonly used for a variety of epilepsies. However, dose related side effects sometimes limit its use. A new extended release formulation of divalproex sodium provides more consistent serum levels and reduces peak serum valproate levels. Reduction in peak serum valproate levels may also reduce dose related side effects including gastrointestinal distress, tremor, somnolence, hair loss and weight gain, improving compliance and activities of daily living.
METHODS: We reviewed 20 patients switched from standard divalproex sodium to the extended release formulation. We evaluated both seizure control and tolerability.
RESULTS: Patients ranged in age from 6 to 75. Improvement was noted in all patients with respect to tolerability. Specifically, reductions in tremor, nausea, somnolence and subjective reports of less hair loss and weight gain were noted. Additionally, several patients were able to tolerate increased doses leading to improved seizure control. Doses of the extended release formulation ranged from 500 to 4000mg. Although the extended release formulation is designed for single daily dosing, our patients were instructed to take the medication twice daily for safety reasons.
CONCLUSIONS: Based on this review, the extended release formulation of divalproex sodium offers an improved side effect profile and the potential for increased seizure control. The significance of this finding is substantial. Patients who respond to divalproex sodium can have a reduction in side effects. Patients who have not adequately responded can be challenged with increased doses. Additionally, compliance will improve with a reduction in the number of total daily doses.
Disclosure: Honoraria - Michael C. Smith, M.D. is a Member of Abbott Speakers Bureau and a Member of the National Advisory Board of Abbott