Emergency treatment--a possibility

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Posted by Bob Johnson ( on December 07, 2000 at 12:43:03:

If nothing is working for you to abort an attack, you might print this out and stick under your doc's nose.

While is uses the "M"-word some Cluster folks have been using this med with good results.

Intravenous Valproate Rapidly Aborts Migraine Headaches

WESTPORT, CT (Reuters Health) Dec 06 - In a preliminary report, published in the October issue of Headache, investigators indicate that intravenous valproate is safe and effective in treating migraines. Further, this therapy appears to provide rapid onset of relief.

Dr. Ninan T. Mathew, and colleagues from the Houston Headache Clinic, administered 300 mg of intravenous valproate sodium to 61 patients who presented to the clinic with acute migraine.

Overall, 73% of patients experienced significant improvement in pain. Patients began noticing relief at a mean of 8 minutes. Meaningful relief was noted on average in 16 minutes and complete relief had occurred at a mean of 25 minutes.

Besides significantly reducing headache pain, valproate also decreased associated symptoms like nausea, disability, and photophobia. Patients appeared more alert after treatment and no serious adverse events were noted.

Regarding the improved alertness observed in their patients, the authors state "that intravenous valproate may have advantages over other protocols, such as those utilizing dihydroergotamine (DHE) or dopamine antagonists, which may result in marked somnolence."

Intravenous valproate may be an alternative in patients who cannot tolerate DHE or in those in whom DHE is contraindicated, Dr. Mathew's team mentions. It may also be useful in patients who have recently taken ergotamine, DHE, or triptans and present acutely to their healthcare provider.

Reached for comment, Dr. Mathew told Reuters Health that since the study he has been treating patients with intravenous valproate almost daily. The lack of side effects, such as nausea, makes valproate a particularly attractive treatment option, he stated. He did stress, however, that valproate should not be used in pregnant patients or in those with liver disease.

While numerous studies have shown oral valproate is effective in preventing migraines, this is the first study to examine the safety and efficacy of intravenous valproate in the treatment of acute migraine attacks.

Headache 2000;40:720-723.

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