Archives 1992-2013

2001, volume 10, suplement 1

Review article

Pharmacological properties of valproic acid

DAGMARA MIROWSKA, ANDRZEJ CZŁONKOWSKI
Postępy Psychiatrii i Neurologii, 2001, 10 suplement 1 (13), 3-9

Basic pharmacodynamic and pharmacokinetic properties of valproic acid are overviewed in the paper, as well as the principles of VPA administration, side effects, and interactions. (Ed.)

Review article

The role of valproic acid and its salts in the treatment of epilepsy

Danuta Rościszewska
Postępy Psychiatrii i Neurologii, 2001, 10 suplement 1 (13), 11-18

An attempt was made to overview the knowledge about the valproic acid and sodium valproate (Depakine) clinical application, with the emphasis on practical aspects. Valproic acid is regarded as a first-line drug in the treatment of epilepsy. It is very effective in cases of primary generalized epilepsy (with myoclonic and tonic-clonic seizures, as well as absences). Sodium valproate is a drug of choice in juvenile myoclonic epilepsy. Recent studies indicate the drug efficacy in the treatment of complex partial seizures, both as monotherapy and adjunctive therapy. Efficacy of valproic acid is comparable to that of ethosuximide in the treatment of absence seizures, and to carbamazepine and phenytoin – in the treatment of both tonic-clonic and partial seizures. Valproic acid monotherapy does not require drug concentration monitoring in all patients. The most frequent dose-related side effect is tremor. Other side effects include weight gain and hair loss. Idiosyncratic reactions are rare. As in the case of other antiepileptic drugs, there is a risk of teratogenesis, therefore a very careful assessment during pregnancy is necessary. Research findings indicate that VPA intravenous administration is highly effective in status epilepticus. Conclusions: Valproic acid and its salts present a broad spectrum of anticonvulsant activity, do not induce other types of seizures, and do not disturb cognitive functions. In practice, the choice among first-line drugs may be based on their different side effect profiles.

Review article

The role of valproates in migraine and related headaches

Wojciech Kozubski, ANTONI PRUSIŃSKI
Postępy Psychiatrii i Neurologii, 2001, 10, suplement 1 (13), 19-23

Possibilities of valproic acid and its salts administration in the preventive treatment of spontaneous headaches are discussed in the paper. Particular attention is paid to the preventive treatment in migraine, and results of pilot studies and controlled trials on the application of valproates in the prevention of this condition are reported. Attempts at VPA treatment of other idiopathic headaches (cluster headache, tension headache, and chronic daily headache) are also briefly outlined. Finally, possible side effects of the treatment are presented.

Review article

Valproic acid derivatives in t he treatment o f mental, and particularly – affective disorders

STANISŁAW PUŻYŃSKI
Postępy Psychiatrii i Neurologii, 2001, 10, suplement 1 (13), 25-34

It follows from a review of the ample literature on the use of valproic acid derivatives in the treatment of mental disorders that valproic acid has in addition to its anticonvulsant action also a clear psychotropic effect. The latter can be effectively applied in the prevention of bipolar affective disorder, as we/l as in the treatment of manic syndromes. Valproic acid usefulness in other mental disorders (depression, anxiety disorders, dysphoric states) seems probable, but requires further study. Administration of valproates requires that contraindications should be strictly observed and the treatment should be monitored, with particular attention paid to junctions of the liver.