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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
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