Matching articles for "valproic acid"

Comparison Table: Some Oral Antiseizure Medications (online only)

   
The Medical Letter on Drugs and Therapeutics • August 5, 2024;  (Issue 1708)
...
View the Comparison Table: Some Oral Antiseizure Medications
Med Lett Drugs Ther. 2024 Aug 5;66(1708):e133-40 | Show Full IntroductionHide Full Introduction

Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • August 5, 2024;  (Issue 1708)
When used for the appropriate seizure type, antiseizure medications (ASMs) are roughly equivalent in efficacy. In addition to the seizure type, the choice of drug is usually based on factors such as ease of...
When used for the appropriate seizure type, antiseizure medications (ASMs) are roughly equivalent in efficacy. In addition to the seizure type, the choice of drug is usually based on factors such as ease of use, spectrum of activity, adverse effects, interactions with other drugs, presence of comorbid conditions, suitability for elderly persons and those with childbearing potential, and cost. Treatment should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures persist, expert clinicians generally try at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs at the same time.
Med Lett Drugs Ther. 2024 Aug 5;66(1708):121-8 | Show Full IntroductionHide Full Introduction

Drugs for Bipolar Disorder

   
The Medical Letter on Drugs and Therapeutics • April 1, 2024;  (Issue 1699)
Bipolar disorder is characterized by episodes of mania, hypomania, and depression. Recurrences of manic or (more frequently) depressive symptoms are common. About 15-20% of patients with bipolar disorder...
Bipolar disorder is characterized by episodes of mania, hypomania, and depression. Recurrences of manic or (more frequently) depressive symptoms are common. About 15-20% of patients with bipolar disorder die by suicide.
Med Lett Drugs Ther. 2024 Apr 1;66(1699):49-54 | Show Full IntroductionHide Full Introduction

Comparison Table: Some Drugs for Migraine Prevention in Adults (online only)

   
The Medical Letter on Drugs and Therapeutics • June 12, 2023;  (Issue 1678)
...
View the Comparison Table: Some Drugs for Migraine Prevention in Adults
Med Lett Drugs Ther. 2023 Jun 12;65(1678):e100-2 | Show Full IntroductionHide Full Introduction

Drugs for Migraine

   
The Medical Letter on Drugs and Therapeutics • June 12, 2023;  (Issue 1678)
An oral nonopioid analgesic is often sufficient for acute treatment of mild to moderate migraine pain without severe nausea or vomiting. A triptan is the drug of choice for treatment of moderate to...
An oral nonopioid analgesic is often sufficient for acute treatment of mild to moderate migraine pain without severe nausea or vomiting. A triptan is the drug of choice for treatment of moderate to severe migraine in most patients without vascular disease. Treatment of pain when it is still mild to moderate in intensity improves headache response and reduces the risk of recurrence.
Med Lett Drugs Ther. 2023 Jun 12;65(1678):89-96 | Show Full IntroductionHide Full Introduction

Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • July 31, 2017;  (Issue 1526)
Treatment of epilepsy should begin with a single antiepileptic drug (AED), increasing its dosage gradually until seizures are controlled or adverse effects become intolerable. If seizures...
Treatment of epilepsy should begin with a single antiepileptic drug (AED), increasing its dosage gradually until seizures are controlled or adverse effects become intolerable. If seizures persist, specialists generally recommend trying at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs concurrently. When used for the appropriate seizure type, AEDs are roughly equivalent in efficacy. Drug choice is usually based on factors such as ease of use, adverse effects, drug interactions, presence of comorbidities, and cost.
Med Lett Drugs Ther. 2017 Jul 31;59(1526):121-30 | Show Full IntroductionHide Full Introduction

Comparison Table: Some Oral Antiepileptic Drugs (online only)

   
The Medical Letter on Drugs and Therapeutics • July 31, 2017;  (Issue 1526)
...
View the Comparison Table: Some Oral Antiepileptic Drugs
Med Lett Drugs Ther. 2017 Jul 31;59(1526):e130-6 | Show Full IntroductionHide Full Introduction

Drugs for Bipolar Disorder

   
The Medical Letter on Drugs and Therapeutics • August 15, 2016;  (Issue 1501)
Bipolar disorder is characterized by intermittent episodes of mania and/or depression. Even with maintenance treatment, recurrences of manic or (more frequently) depressive episodes are common. Some of the...
Bipolar disorder is characterized by intermittent episodes of mania and/or depression. Even with maintenance treatment, recurrences of manic or (more frequently) depressive episodes are common. Some of the drugs and dosages recommended here have not been approved by the FDA for use in bipolar disorder.
Med Lett Drugs Ther. 2016 Aug 15;58(1501):103-6 | Show Full IntroductionHide Full Introduction

Topiramate Extended-Release (Trokendi XR) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • October 28, 2013;  (Issue 1428)
The FDA has approved a once-daily extended-release (ER) formulation of the antiepileptic topiramate (Trokendi XR – Supernus) for initial monotherapy in patients ≥10 years old with partial onset seizures...
The FDA has approved a once-daily extended-release (ER) formulation of the antiepileptic topiramate (Trokendi XR – Supernus) for initial monotherapy in patients ≥10 years old with partial onset seizures or primary generalized tonic-clonic seizures and for adjunctive therapy in patients ≥6 years old with partial onset seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox-Gastaut syndrome. Topiramate has been available for many years as an immediate-release (IR) formulation (Topamax, and generics) for the same indications in patients ≥2 years old
Med Lett Drugs Ther. 2013 Oct 28;55(1428):87-8 | Show Full IntroductionHide Full Introduction

In Brief: Warning Against Use of Valproate for Migraine Prevention During Pregnancy

   
The Medical Letter on Drugs and Therapeutics • June 10, 2013;  (Issue 1418)
The FDA is advising health care professionals not to prescribe valproate sodium (Depacon), valproic acid (Depakene, Stavzor, and generics) or divalproex sodium (Depakote, Depakote ER, and generics) for migraine...
The FDA is advising health care professionals not to prescribe valproate sodium (Depacon), valproic acid (Depakene, Stavzor, and generics) or divalproex sodium (Depakote, Depakote ER, and generics) for migraine prevention in pregnant women because a recently published study showed that IQ scores are decreased in children of mothers who took these drugs during pregnancy. The FDA recommends avoiding valproate altogether, if possible, in women of childbearing age.1

VALPROATE — Valproic acid and divalproex sodium dissociate to valproate in the GI tract. Valproate is considered the drug of choice for treatment of primary generalized tonic-clonic seizures. It is one of many drugs used for treatment of bipolar disorder and prevention of migraine.2,3

EFFECTS ON CHILDREN — The recent publication is the third in a series comparing IQ scores in a cohort of children exposed to various antiepileptic drugs throughout pregnancy.4 At 3 years of age, 4.5 years, and now 6 years, IQ scores were 6-11 points lower in children exposed to valproate than in those exposed to carbamazepine, lamotrigine or phenytoin. In addition, valproate taken during pregnancy has the highest demonstrated risk, compared to other antiepileptic drugs, of major congenital malformations, including oral cleft, cardiac, urinary tract and neural tube defects, and most recently, it has been associated with an increased risk of autism.5,6

USE IN MIGRAINE — Beta blockers such as propranolol and timolol and the antiepileptics valproate and topiramate are the drugs generally used for prevention of migraine. There is no evidence that any one is more effective than any other. Because of concerns about possible adverse fetal effects with all of these agents, preventive therapy for migraine is generally not recommended during pregnancy.7

CONCLUSION — Taking valproate during pregnancy can lower the IQ of exposed children and possibly could have other devastating effects. Those risks are certainly not worth taking for prevention of migraine.

1. FDA Drug Safety Communication: Valproate anti-seizure products contraindicated for migraine prevention in pregnant women due to decreased IQ scores in exposed children. Available at www.fda.gov/Drugs/DrugSafety/ucm350684.htm. Accessed May 28, 2013.

2. Drugs for psychiatric disorders. Treat Guidel Med Lett 2013; 11:53.

3. SD Silverstein et al. Evidence-based guideline update: pharmacologic treatment for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 2012; 78:1337.

4. KJ Meador et al. Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study. Lancet Neurology 2013; 12:244.

5. J Christensen et al. Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism. JAMA 2013; 309:1696.

6. KJ Meador and DW Loring. Risks of in utero exposure to valproate. JAMA 2013; 309:1730.

7. Drugs for migraine. Treat Guidel Med Lett 2011; 9:7.

Download complete U.S. English article

Med Lett Drugs Ther. 2013 Jun 10;55(1418):45 | Show Full IntroductionHide Full Introduction

Drugs for Psychiatric Disorders

   
The Medical Letter on Drugs and Therapeutics • June 1, 2013;  (Issue 130)
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) can be used for many...
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) can be used for many of them as well. Electroconvulsive therapy (ECT) has a long history of efficacy and safety when drugs are ineffective or cannot be used.
Treat Guidel Med Lett. 2013 Jun;11(130):53-64 | Show Full IntroductionHide Full Introduction

Ezogabine (Potiga) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • August 20, 2012;  (Issue 1397)
The FDA has approved ezogabine (ee-ZOE-ga-been; Potiga – GSK/Valeant) for oral adjunctive treatment of partial-onset seizures in adults. Ezogabine is available in Europe as retigabine...
The FDA has approved ezogabine (ee-ZOE-ga-been; Potiga – GSK/Valeant) for oral adjunctive treatment of partial-onset seizures in adults. Ezogabine is available in Europe as retigabine (Trobalt).
Med Lett Drugs Ther. 2012 Aug 20;54(1397):65-7 | Show Full IntroductionHide Full Introduction

Drugs for Depression and Bipolar Disorder

   
The Medical Letter on Drugs and Therapeutics • May 1, 2010;  (Issue 93)
Drugs are not the only treatment for mood disorders. Psychotherapy remains an important component in the management of these disorders, and electroconvulsive therapy (ECT) has a long history of efficacy and...
Drugs are not the only treatment for mood disorders. Psychotherapy remains an important component in the management of these disorders, and electroconvulsive therapy (ECT) has a long history of efficacy and safety when drugs are ineffective, poorly tolerated or cannot be used. Some drugs are recommended here for indications that have not been approved by the FDA.
Treat Guidel Med Lett. 2010 May;8(93):35-42 | Show Full IntroductionHide Full Introduction

Lacosamide for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • June 29, 2009;  (Issue 1315)
The FDA has approved lacosamide (Vimpat - UCB Pharma) for oral or intravenous (IV) use as add-on therapy in adults with partial-onset...
The FDA has approved lacosamide (Vimpat - UCB Pharma) for oral or intravenous (IV) use as add-on therapy in adults with partial-onset seizures.
Med Lett Drugs Ther. 2009 Jun 29;51(1315):50-2 | Show Full IntroductionHide Full Introduction

Rufinamide (Banzel) for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • March 9, 2009;  (Issue 1307)
Rufinamide (Banzel - Eisai), a triazole derivative structurally unrelated to other marketed antiepileptic drugs (AEDs), has been approved by the FDA for treatment of seizures associated with Lennox-Gastaut...
Rufinamide (Banzel - Eisai), a triazole derivative structurally unrelated to other marketed antiepileptic drugs (AEDs), has been approved by the FDA for treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in patients ≥4 years old.
Med Lett Drugs Ther. 2009 Mar 9;51(1307):18-20 | Show Full IntroductionHide Full Introduction

Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • June 1, 2008;  (Issue 70)
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases...
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases appear inadvisable because of adverse effects, most Medical Letter consultants generally prescribe at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs at the same time. Most antiepileptic drugs initially approved by the FDA only as adjunctive therapy for partial seizures may also be effective for other types of seizures and as monotherapy. Studies suggest that when used for the appropriate seizure type, antiepileptic drugs are roughly equivalent in efficacy. The choice of a drug is usually based on factors such as ease of use, adverse effects and cost.
Treat Guidel Med Lett. 2008 Jun;6(70):37-46 | Show Full IntroductionHide Full Introduction

Drugs for Migraine

   
The Medical Letter on Drugs and Therapeutics • March 1, 2008;  (Issue 67)
Some drugs for treatment of migraine attacks are listed in table 2 on page 18. Drugs for prevention of migraine are listed in table 3 on page 20. Treatment of migraine in the emergency room, which may involve...
Some drugs for treatment of migraine attacks are listed in table 2 on page 18. Drugs for prevention of migraine are listed in table 3 on page 20. Treatment of migraine in the emergency room, which may involve use of intravenous drugs, is not included here.
Treat Guidel Med Lett. 2008 Mar;6(67):17-22 | Show Full IntroductionHide Full Introduction

Doripenem (Doribax) - A New Parenteral Carbapenem

   
The Medical Letter on Drugs and Therapeutics • January 28, 2008;  (Issue 1278)
Doripenem (Doribax - Ortho-McNeil Janssen), an intravenous (IV) carbapenem antibiotic with a spectrum of activity similar to that of imipenem and meropenem, has been approved by the FDA for treatment of...
Doripenem (Doribax - Ortho-McNeil Janssen), an intravenous (IV) carbapenem antibiotic with a spectrum of activity similar to that of imipenem and meropenem, has been approved by the FDA for treatment of complicated intra-abdominal and urinary tract infections. Use of doripenem for treatment of nosocomial pneumonia, including ventilator-associated pneumonia, is still under FDA review.
Med Lett Drugs Ther. 2008 Jan 28;50(1278):5-7 | Show Full IntroductionHide Full Introduction

Drugs for Psychiatric Disorders

   
The Medical Letter on Drugs and Therapeutics • June 1, 2006;  (Issue 46)
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) is used for many of them as...
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) is used for many of them as well. Electroconvulsive therapy (ECT) has a long history of efficacy and safety when drugs are ineffective or cannot be used.
Treat Guidel Med Lett. 2006 Jun;4(46):35-46 | Show Full IntroductionHide Full Introduction

Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • November 1, 2005;  (Issue 39)
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases...
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases appear inadvisable because of adverse effects, most Medical Letter consultants generally prescribe at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs at the same time. Most antiepileptic drugs initially approved by the FDA only as adjunctive therapy for partial seizures may also be effective for other types of seizures and as monotherapy.
Treat Guidel Med Lett. 2005 Nov;3(39):75-82 | Show Full IntroductionHide Full Introduction

Extended-Release Carbamazepine (Equetro) for Bipolar Disorder

   
The Medical Letter on Drugs and Therapeutics • March 28, 2005;  (Issue 1205)
An extended-release formulation of carbamazepine, available since 1997 for treatment of epilepsy, has now been approved under a new name, Equetro, for acute mania and mixed episodes of bipolar disorder....
An extended-release formulation of carbamazepine, available since 1997 for treatment of epilepsy, has now been approved under a new name, Equetro, for acute mania and mixed episodes of bipolar disorder. Although the drug was effective in some patients for up to 6 months, it has not been approved for maintenance treatment. Carbamazepine has not been shown to be more effective than lithium or valproate, and it can cause serious adverse effects.
Med Lett Drugs Ther. 2005 Mar 28;47(1205):27-8 | Show Full IntroductionHide Full Introduction

Topiramate (Topamax) for Prevention of Migraine

   
The Medical Letter on Drugs and Therapeutics • January 31, 2005;  (Issue 1201)
Patients with frequent, severe or disabling migraine headaches may benefit from taking a drug to prevent the attacks. Beta-blockers traditionally have been the prophylactic treatment of choice, but in recent...
Patients with frequent, severe or disabling migraine headaches may benefit from taking a drug to prevent the attacks. Beta-blockers traditionally have been the prophylactic treatment of choice, but in recent years some antiepileptic drugs such as valproate (Depakote, and others) and topiramate (Topamax) have also been used for this indication. Valproate was approved by the FDA for such use in 1996. Now topiramate has also been approved.
Med Lett Drugs Ther. 2005 Jan 31;47(1201):9-10 | Show Full IntroductionHide Full Introduction

L-Carnitine

   
The Medical Letter on Drugs and Therapeutics • November 22, 2004;  (Issue 1196)
Carnitine is a naturally occurring amino acid derivative essential for transport of long-chain fatty acids into mitochondria. It is advertised on the Internet as a dietary supplement that can promote weight...
Carnitine is a naturally occurring amino acid derivative essential for transport of long-chain fatty acids into mitochondria. It is advertised on the Internet as a dietary supplement that can promote weight loss, increase energy, enhance athletic performance and slow aging. Levocarnitine (Carnitor - Sigma-Tau) has been FDA approved for oral and parenteral treatment of primary carnitine deficiency since 1986. Products containing levocarnitine and its synthetic derivative acetyl-L-carnitine are available as dietary supplements in the US.
Med Lett Drugs Ther. 2004 Nov 22;46(1196):95-6 | Show Full IntroductionHide Full Introduction

Drugs for Psychiatric Disorders

   
The Medical Letter on Drugs and Therapeutics • July 1, 2003;  (Issue 11)
The number of drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and...
The number of drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and opinions of Medical Letter consultants. Interactions with other drugs can be found in The Medical Letter Handbook of Adverse Drug Interactions, 2003.
Treat Guidel Med Lett. 2003 Jul;1(11):69-76 | Show Full IntroductionHide Full Introduction

Drugs for Epilepsy

   
The Medical Letter on Drugs and Therapeutics • May 1, 2003;  (Issue 9)
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases...
Treatment of epilepsy should begin with a single drug, increasing the dosage gradually until seizures are controlled or adverse effects become unacceptable. If seizures continue and further dosage increases appear inadvisable because of adverse effects, most Medical Letter consultants generally prescribe at least one and sometimes a second alternative drug as monotherapy before considering use of two drugs at the same time. Most antiepileptic drugs initially approved by the FDA only for adjunctive therapy are probably also effective as monotherapy. Many of the drugs used to treat epilepsy interact with each other (see table beginning on page 63) and with other drugs; for interactions with other drugs, see The Medical Letter Handbook of Adverse Drug Interactions, 2003. The treatment of status epilepticus is not included here.
Treat Guidel Med Lett. 2003 May;1(9):57-64 | Show Full IntroductionHide Full Introduction

Valproate and Other Anticonvulsants For Psychiatric Disorders

   
The Medical Letter on Drugs and Therapeutics • December 11, 2000;  (Issue 1094)
Anticonvulsants are now widely used for treatment of psychiatric illnesses, particularly bipolar disorder. Lithium is the standard drug for treatment of bipolar disorder, but it can cause severe toxicity, serum...
Anticonvulsants are now widely used for treatment of psychiatric illnesses, particularly bipolar disorder. Lithium is the standard drug for treatment of bipolar disorder, but it can cause severe toxicity, serum concentrations must be monitored, and it is not effective in some patients.
Med Lett Drugs Ther. 2000 Dec 11;42(1094):114-5 | Show Full IntroductionHide Full Introduction

Zonisamide (Zonegran) For Epilepsy

   
The Medical Letter on Drugs and Therapeutics • October 2, 2000;  (Issue 1089)
Zonisamide (Zonegran - Elan Pharma), a sulfonamide chemically unrelated to other antiepileptic drugs, has been approved by the FDA for adjunctive use in adults with partial seizures. Zonisamide has been...
Zonisamide (Zonegran - Elan Pharma), a sulfonamide chemically unrelated to other antiepileptic drugs, has been approved by the FDA for adjunctive use in adults with partial seizures. Zonisamide has been available in Japan for more than 10 years.
Med Lett Drugs Ther. 2000 Oct 2;42(1089):94-5 | Show Full IntroductionHide Full Introduction