Depakote for Chronic Cluster

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Posted by Bob Johnson ( on August 11, 2001 at 15:11:08:

Report in HEADACHE QUARTERLY, XII, 2, from Seymour Diamond and his group, "Divalproex sodium in the preventative treatment of cluster headache". The brand name is Depakote.

As is so common, finding a preventive treatment is frustrating because of major individual differences in response to medications, often compounded by the experience of an effective drug stopping working after a period of success. It is this dual dilemma which leads Diamond, and others, to say that our expectations of long term success should be modest. Diamond uses the figure of roughly 60% to define success of any single treatment to prevent CH.

The group in this study were not responding to the standard therapies for prevention of CHRONIC CH.

Using a dose around 825 to 850 mg of Depakote, chronic cluster headache frequency declined almost 54%. The reduction for episodic cluster was almost 59%. "The mean duration of treatment for chronic cluster was 11.1 months." For episodic cluster, patients were "...treated for 2 weeks past remission...then had a stepwise dose reduction based on the dose at the time of remission." (Giving some guidance on the use of Depakote.)

Six of the patients with Chronic CH had remission of their attacks, allowing them to stop using. Only time will tell--for any given individual--whether this reflects a quiet stage of chronic CH or a reversion to an episodic form of cluster.

Bottom line: another in a series of reports which indicate that Depakote is helpful for a significant percentage of us.

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