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Intravenous Valproate Sodium (Depacon) Aborts
Migraine Rapidly: A Preliminary Report
Ninan T. Mathew, MD; Jayasree Kailasam, MD;
Lori Meadors, PA-C; Oleg Chernyschev, MD;
Paula Gentry, BS
Posted August 2003
Headache 2003;40:720-723

Objective: This study was designed to investigate the efficacy and safety of intravenous valproate in the treatment of acute migraine attacks.

Method: After obtaining written informed consent, 61 patients presenting to a clinic with acute migraine were infused with 300mg of intravenous valproate sodium. Sixty-six attacks were treated. The time at the beginning of infusion; the time at the end of infusion; the time to onset of relief of headache, nausea, and other associated symptoms; the time to meaningful relief; and the time to complete relief were recorded. Patientís pulse, blood pressure, and respiration were monitored. Adverse events were recorded.

Results: Mean time to onset of relief was 8 minutes, mean time to meaningful relief was 16 minutes, and mean time to complete relief was 25 minutes. A reduction in pain from severe or moderate to mild or no pain in 30 minutes was reported in 37 of 66 attacks; in 11 attacks, a reduction of more than 50% in headache severity in 30 minutes was reported. Thus, 48 (73%) of 66 attacks had significant improvement. After treatment with valproate, headache severity was significantly decreased (P<.0001); nausea, disability, and photophobia decreased; and patients became more alert. No serious adverse events were reported.

Conclusion: Intravenous valproate appears to be safe and effective for the acute treatment of migraine. Double-blind placebo-controlled studies to further investigate the use of this agent in acute treatment of migraine attacks are warranted.