Intravenous Valproate Sodium in the Treatment of Daily Headache
Article first published online: 15 AUG 2002
Headache: The Journal of Head and Face Pain
Volume 42, Issue 6, pages 519–522, June 2002
How to Cite
Schwartz, T. H., Karpitskiy, V. V. and Sohn, R. S. (2002), Intravenous Valproate Sodium in the Treatment of Daily Headache. Headache: The Journal of Head and Face Pain, 42: 519–522. doi: 10.1046/j.1526-4610.2002.02127.x
- Issue published online: 15 AUG 2002
- Article first published online: 15 AUG 2002
- Accepted for publication March 7, 2002.
- valproate sodium
Background.—Treatment of chronic daily headache/transformed migraine is challenging, especially when it is complicated by overuse of analgesics, triptans, or both. One common approach involves the use of repetitive intravenous dihydroergotamine. We investigated the use of intravenous valproate sodium in the treatment of chronic daily headache/transformed migraine in patients who had contraindications to the use of or had failed treatment with dihydroergotamine.
Methods.—We administered intravenous valproate sodium (Depacon) to patients with chronic daily headache/transformed migraine (loading dose 15 mg/kg, followed by 5 mg/kg every 8 hours). All analgesics and triptans were discontinued prior to treatment with divalproex sodium, and preventative medications for migraine were begun or continued. All patients received instruction in behavioral modification and the proper use of analgesics and triptans.
Results.—Improvement in headache was reported by 80% of the patients treated, and valproate sodium was tolerated well by most.
Conclusion.—Intravenous valproate sodium may be of assistance in the initial management of patients with chronic daily headache/transformed migraine and analgesic/triptan overuse, especially when dihydroergotamine is ineffective or contraindicated.