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Valproic Acid (Depakene®, Depakote®)

By: Dr. Nicholas Dodman

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Overview

  • Seizure disorders or convulsions are the physical manifestations of uncontrolled electrical activity in the brain. Recurrent seizures are often classified as epilepsy (fits). While there are numerous causes of convulsions, treatments that control epileptic seizures are relatively limited. Commonly used anticonvulsant drugs include phenobarbital, diazepam (Valium®), and primidone. A less commonly used drug is valproic acid.
  • Valproic acid is an anticonvulsant effective in the treatment of partial and generalized seizures. It can help reduce the frequency and severity of seizures. Valproic acid is often used with other anticonvulsant drugs such as phenobarbital, a barbiturate drug.
  • The mechanism of valproic acid's anti-seizure effect is thought to be associated with increased brain concentrations of gamma-aminobutyric acid (GABA). However, it also may affect sodium channels (bringing about stabilization of cell membranes).
  • Valproic acid is a prescription drug and can only be obtained from a veterinarian or by prescription from a veterinarian.
  • This drug is not approved for use in animals by the Food and Drug Administration (FDA) but it may be prescribed legally by veterinarians as an extra-label drug.

    Brand Names and Other Names

  • This drug is registered for use in humans only.
  • Human formulations: Depakene® (Abbott Pharmaceuticals), Depakote® (Abbott Pharmaceuticals), and various generic preparations.
  • Veterinary formulations: None

    Uses of Valproic acid

  • Valproic acid is most commonly used to treat seizure disorders, including epilepsy in dogs. Valproate is metabolized rapidly by dogs and this fact limits its duration and thus usefulness. For this reason, it is usually employed in combination with other anticonvulsants. Because of valproic acid's rapid metabolism in dogs, a delayed release form, Depakote®, may be more appropriate to employ in this species.

    Precautions and Side Effects

  • While generally safe and effective when prescribed by a veterinarian, valproic acid may cause unacceptable side effects in some animals.
  • Valproic acid should not be used in animals with known hypersensitivity or allergy to the drug.
  • Valproic acid should be used with caution in animals with heart or liver disease.
  • Valproic acid may interact with other medications. Consult with your veterinarian to determine if other drugs your pet is receiving may interact with valproic acid. Such drugs may include acepromazine, cimetidine, aspirin, and felbamate.
  • Adverse effects associated with valproic acid include hyperactivity and hair loss (in cats). Human studies have shown that liver and blood problems, such as lymphocytosis, leukopenia, eosinophilia, and anemia, may be associated with the use of valproic acid.

    How Valproic acid Is Supplied

  • Valproic acid is available as a 250 mg capsule or 125 mg sprinkle capsule. In addition, delayed release tablets are available in 120 mg, 250 mg, and 500 mg sizes.

    Dosing Information

  • Medication should never be administered without first consulting your veterinarian.

  • In dogs, there have been various dosing schedules recommended including:

    1. 7.5 to 100 mg per pound per day (15 to 200 mg/kg/day) divided and given every 6 to 8 hours
    2. 85 to 90 mg per pound per day (170 to 180 mg/kg/day) divided into 3 equal doses of enteric-coated tablets.
    3. 15 to 100 mg per pound (30 to 200 mg/kg) orally every 8 hours
    4. 7.5 to 100 mg per pound (15 to 200 mg/kg) orally every 6 to 8 hours

  • The dosage is often altered based on therapeutic plasma levels (supposed to be in the order of 40 to 100 ìg/mL).
  • In cats, the clinical dose has not been established. Some believe that valproic acid is unsuitable for use in cats because of its short half-life and unacceptable side effects. Others disagree and favor its use in felines.
  • The duration of administration of valproic acid depends on the condition being treated, response to the medication, and the development of any adverse effects. Be certain to complete the prescription unless specifically directed by your veterinarian. Even if your pet feels better, the entire treatment plan should be completed to prevent relapse or prevent the development of resistance.




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