Latest research on Valproate

Valproic acid, supplied as the sodium salt valproate semisodium or divalproex sodium, is a fatty acid with anticonvulsant properties used in the treatment of epilepsy. The mechanisms of its therapeutic actions are not well understood. It may act by increasing gamma-aminobutyric acid levels in the brain or by altering the properties of voltage dependent sodium channels. Typically supplied in the sodium salt form (CAS number: 76584-70-8). Valproic Acid is also a histone deacetylase inhibitor and is under investigation for treatment of HIV and various cancers.

Latest findings

We recently described a patient with IRTAs and severe dissociative and auto-aggressive symptoms who responded very well to therapy with Valproate as well as Topiramate later in the course (Tebartz van Elst et al., 2011). [source, 2016]
As expected, several small molecules have been identified to function as inhibitors of histone demethylases, such as BIX-01294, RG108, Parnate, 5-Azacytidine, or 3 histone deacetylase inhibitors (Suberoylanilide hydroxamic acid, trichostatin A, and VALPROIC acid). [source, 2016]
In addition, no difference (p = 0.8) was observed in the prevalence of MetS in subjects on antipsychotic monotherapy (22.8%) compared to subjects taking antipsychotics combined with sodium Valproate and antidepressant medication (24.5%) or those subjects taking two or more antipsychotics (21.6%, p = 0.9). [source, 2016]
Too few subjects were taking antipsychotics combined with antidepressants and sodium Valproate only for a separate analysis. [source, 2016]
In this study, 18,5% of patients were prescribed two or more antipsychotics, and 35,5% were on antipsychotics combined with sodium Valproate. [source, 2016]
Although it has been shown that combining psychotropic medications results in the potentiating of the metabolic side effects of each of the individual medications [44], the results of this study support and extend the evidence for no independent association between MetS and the prescription of two or more antipsychotics [45] or antipsychotics combined with sodium Valproate [46]. [source, 2016]
Valproate (VPA) is a histone deacetylation enzyme inhibitor (HDACI) that increases the acetylation level of histones and promotes gene transcription. [source, 2016]
Intravenous (IV) Diazepam was administered as a first-line antiepileptic drug (AED), followed by IV second-line AEDs if SE persisted (e.g., VALPROIC acid, Phenobarbital). [source, 2016]
Of the 149 subjects on polytherapy, 98 (35.5%) were taking an antipsychotic combined with sodium Valproate, and 51 (15.5%) were taking two or more antipsychotics at the same time.Of the 98 subjects on sodium Valproate 6 (2.2%) subjects were also taking an antidepressant (5 subjects were on a Selective Serotonin Reuptake Inhibitor and 1 was on a Serotonin Noradrenalin Reuptake Inhibitor) and only one subject was taking Lithium. [source, 2016]
We didn’t give him Lithium salts any more for the reason of he was 76-year-old, and had a history of Lithium intoxication, we gave him Depakine 500 mg/day, Olanzapine 1.25 mg/day instead, 5 years later, he is in stable condition, and have no adverse reaction. [source, 2016]