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.
Cholestyramine (Questran) can reduce the absorption of valproic acid from the
intestine and reduce its effectiveness. Therefore, valproic acid should be taken
at least 2 hours before or 6 hours after doses of cholestyramine.
Valproic acid can significantly decrease the elimination of lamotrigine
(Lamictal), ethosuximide (Zarontin), diazepam (Valium), zidovudine (AZT) and
phenobarbital, thereby increasing their concentrations in blood and leading to
toxicity. Valproic acid also increases the blood levels of warfarin and
phenytoin by displacing them from blood proteins that they bind to. Since
increased blood concentrations of these drugs may lead to an increase in side
effects, the dose of warfarin and phenytoin may need to be altered when they are
taken with valproic acid.
PREGNANCY: The use of valproic acid
during pregnancy has been associated with
fetal abnormalities such as spina bifida,
cardiovascular abnormalities, and
neural tube defects. The risk of spina bifida in the offspring of mothers taking
valproic acid during pregnancy is 1%-2%. Valproic acid also may cause reduced
clotting in the mother and baby. Because of the risk of harm to the newborn,
valproic acid should only be used by pregnant women when its benefits outweigh
the risks.
NURSING MOTHERS: The concentration of valproic acid in breast milk of women
taking valproic acid is 1-10%. Although the effect on the nursing infant, is not
certain, nursing mothers probably should not
breastfeeding if they are taking
valproic acid.
SIDE EFFECTS: The most common side effects with valproic acid therapy are
drowsiness, dizziness, nausea, vomiting, indigestion, diarrhea, weight loss and
tremors. Divalproex may have a lower incidence of stomach upset, and taking
valproic acid or divalproex with food can reduce the stomach upset. Valproic
acid also causes skin reactions such as
alopecia (loss of hair), rash, itching
and sensitivity to sunlight.
The most serious side effects due to valproic acid are liver injury,
pancreatitis and abnormal bleeding. Liver injury is most common in the first 6
months of treatment. It also is more common in children, especially children
less than two years old. Persons taking more than one type of anticonvulsant
seem to be at higher risk. Symptoms of liver damage include jaundice, malaise,
weakness, swelling in the face, loss of appetite and vomiting. Pancreatitis due
to valproic acid can occur early in treatment or after several years of use.
Symptoms of pancreatitis are unexplained weight loss, nausea, vomiting and
severe abdominal pain. Valproic acid inhibits the formation of blood clots by
interfering with the clot-promoting effects of platelets. This can cause
abnormal bleeding.
Antiepileptic medications have been associated with an increased risk of
suicidal thinking and behavior. Anyone considering the use of antiepileptic
drugs must balance this risk of suicide with the clinical need for the
antiepileptic drug. Patients who begin antiepileptic therapy should be closely
observed for clinical worsening, suicidal thoughts or unusual changes in
behavior.
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.
Neurology RSS
Healthy Living Tips
This site complies with the