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Published Online, 26 February 2008, www.theannals.com, DOI 10.1345/aph.1K531.
 The Annals of Pharmacotherapy: Vol. 42, No. 3, pp. 403-407. DOI 10.1345/aph.1K531
© 2008 Harvey Whitney Books Company.
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DRUG INFORMATION ROUNDS

Use of Intravenous Valproic Acid for Acute Migraine

Lawrence A Frazee, PharmD BCPS

Pharmacotherapy Specialist, Internal Medicine, Akron General Medical Center, Akron, OH; Associate Professor of Clinical Pharmacology in Internal Medicine, Northeastern Ohio Universities College of Medicine, Rootstown, OH

Kimberly C Foraker, PharmD

PGY-1 Pharmacy Resident, University of Tennessee Medical Center, Knoxville, TN

Reprints: Dr. Frazee, Akron General Medical Center, 400 Wabash Ave., Akron, OH 44307, fax 330/996-2395, lfrazee{at}agmc.org

OBJECTIVE: To review the literature regarding the use of intravenous valproic acid in aborting an acute migraine attack.

DATA SOURCES: A MEDLINE (1967-June 2007) and bibliographic search of the English-language literature was conducted using the search terms valproic acid and migraine disorders.

STUDY SELECTION AND DATA EXTRACTION: All articles indentified through the search were included.

DATA SYNTHESIS: Divalproex sodium is approved by the Food and Drug Administration for the prevention of migraine headaches. The use of intravenous valproic acid has been studied as a possible treatment for acute migraine. Available studies are small, mostly open-label and non-placebo-controlled, and used variable doses. Valproic acid has not been shown to be superior to comparator drugs and was inferior to prochlorperazine in one trial.

CONCLUSIONS: Intravenous valproic acid has not been proven effective for acute migraine treatment. Future trials should be larger, placebo-controlled, and use a standardized dose and outcome measures.

Key Words: migraine headache, valproic acid

Published Online, February 26, 2008. www.theannals.com, DOI 10.1345/aph.1K531




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