Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
BRAND NAME: Depakote, Depakote ER, Depakene, Depacon, Stavzor
DRUG CLASS AND MECHANISM: Valproic acid and its derivative, divalproex, are
oral drugs that are used for the treatment of convulsions, migraines and bipolar
disorder. The active ingredient in both products is valproic acid. Divalproex is
converted to valproic acid in the stomach. Scientists do not know the mechanism
of action of valproic acid. The most popular theory is that valproic acid exerts
its effects by increasing the concentration of gamma-aminobutyric acid (GABA) in
the brain. GABA is a neurotransmitter, a chemical that nerves use to communicate
with one another. The FDA approved valproic acid in February, 1978 and
divalproex in March 1983.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS:
Delayed release tablets: 125, 250 and 500 mg.
Extended release
tablets: 250 and 500 mg.
Sprinkle capsules: 125 mg.
Capsules: 250 mg.
Syrup: 250
mg/5 ml.
Injection: 100 mg/5 ml.
STORAGE: Valproic acid should be stored at room temperature, 15-30 C (59-86
F).
DOSING: For seizures, therapy is initiated at 10-15 mg/kg/day and increased
by 5-10 mg/kg/day every week to achieve the desired response. Response usually
is seen when the blood concentration of valproic acid is 50-100 mcg/mL.
For acute mania due to bipolar disorder, treatment is started at 750 mg per
day of delayed-release tablets in divided doses. The dose should be increased
rapidly to achieve the desired effect. The maximum dose is 60 mg/kg/day.
The recommended dose for prevention of migraines is 250 mg twice daily of
delayed-release tablets. The maximum recommended dose is 1000 mg/day. When using
extended release tablets, the recommended dose is 500-1000 mg given once daily.
DRUG INTERACTIONS: Valproic acid has numerous suspected or proven
drug
interactions. Valproic acid can reduce the number of platelets or inhibit the
ability of platelets to stick together and
form a blood clot. Therefore, it may
exaggerate the effects of other medications which inhibit the stickiness of
platelets or inhibit other steps in the clotting of blood. This can lead to
abnormal bleeding due to the inability of blood to clot. Such medications
include warfarin (Coumadin), heparin or low-molecular weight heparin (Lovenox),
clopidogrel (Plavix), ticlopidine (Ticlid), and
nonsteroidal antiinflammatory
drugs (NSAIDs) such as ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve),
indomethacin (Indocin), nabumetone (Relafen), diclofenac (Voltaren, Cataflam,
Arthrotec), ketorolac (Toradol) and
aspirin.
Aspirin and felbamate (Felbatol) can reduce the elimination of valproic acid
and result in elevated blood concentrations of valproic acid and toxicity due to
the valproic acid.
Rifampin (Rifadin, Rimactane), carbamazepine (Tegretol), phenytoin (Dilantin)
can increase the elimination of valproic acid, thereby reducing blood
concentrations. Since this can result in loss of seizure control and seizures,
adjustments in the dose of valproic acid may be necessary if these medications
are begun.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Migraine is usually periodic attacks of headaches on one or both sides of the head. These may be accompanied by nausea, vomiting, increased sensitivity of the eyes to light (photophobia), increased sensitivity to sound (phonophobia), dizziness, blurred vision, cognitive disturbances, and other symptoms. Treatments for migraine headache include therapies that may or may not involve medications.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Drug-induced liver diseases are diseases of the liver that are caused by physician-prescribed medications, OTC medications, vitamins, hormones, herbs, illicit (“recreational”) drugs, and environmental toxins. There are three types of liver toxicity; dose-dependent toxicity, idiosyncratic toxicity, and drug allergy. The types of liver disease drugs cause include: mild elevations of blood levels of liver enzymes, hepatitis, necrosis, cholestasis, steatosis, cirrhosis, mixed disease, fulminant hepatitis, and blood clots.
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood stabilizer medications, antidepressants, and psychotherapy.
Borderline personality disorder is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This instability often disrupts family and work life, long-term planning, and the individual's sense of self-identity. Originally thought to be at the "borderline" of psychosis, people with borderline personality disorder (BPD) suffer from a disorder of emotion regulation.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Fragile X syndrome is the most common inherited form of mental retardation. It's caused by a mutation on the X chromosome. People with Fragile X syndrome suffer from physical, social, emotional, speech, language, sensory, intelligence, and learning impairments. There is no definitive treatment for Fragile X, though there are ways to minimize the symptoms.
Seizures are divided into two categories: generalized and partial. Generalized seizures are produced by electrical impulses from throughout the brain, while partial seizures are produced by electrical impulses in a small part of the brain. Seizure symptoms include unconsciousness, convulsions, and muscle rigidity.
Bipolar disorder, or manic-depressive illness, is a disorder that causes unusual and extreme mood changes. Symptoms of bipolar disorder in children and teens include having trouble concentrating, behaving in risky ways and losing interest in activities they once enjoyed. Treatment for bipolar disorder in children and teenagers incorporates psychotherapy and medications.
Taking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.
Depressive disorders have been with mankind since the beginning of recorded history. In the Bible, King David, as well as Job, suffered from this affliction. Hippocrates referred to depression as melancholia, which literally means black bile. Black bile, along with blood, phlegm, and yellow bile were the four humors (fluids) that described the basic medical physiology theory of that time. Depression, also referred to as clinical depression, has been portrayed in literature and the arts for hundreds of years, but what do we mean today when we refer to a depressive disorder? In the 19th century, depression was seen as an inherited weakness of temperament. In the first half of the 20th century, Freud linked the development of depression to guilt and conflict. John Cheever, the author and a modern sufferer of depressive disorder, wrote of conflict and experiences with his parents as influencing his development of depression.
Neurology RSS
Healthy Living Tips
This site complies with the