Valproic acid for pain? Really?

Specialties CRNA

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Specializes in ER, HH, CTICU, corrections, cardiology, hospice.

Has anybody heard of this? In looking around on the web I'm coming up goose eggs. I have to sign off on this to my cynical patients and I'M NOT convinced. Any help? Thanks Y'all.

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i found this when i googled your question: http://www.cancer.org/docroot/CDG/content/CDG_valproic_acid.asp

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Specializes in psych, addictions, hospice, education.

I've heard of it. It falls into the same category as using Neurontin for pain...it's used as an adjunct to all the other meds and treatments, and is especially useful for nerve pain.

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Yes, I heard oif this and even given for Pain.If you want pain management

explained with the Biochemical changes in the brain and why Anti-Convulsants work for pain see. Dr Gutman MD in Orlando FL Web page on pain. He i explains this in Pain management.

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Specializes in Midwifery, Case Management, Addictions.

Valproic acid is used for treatment of both migraine and neuropathy. The 6th edition (2002) of the book Pain Management: A Practical Guide for Clinicians by Richard Weiner, pg. 185, classifies valproic acid as a membrane stabilizing agent and states that its mechanism of action involves "blockage of frequency and voltage-dependent sodium channels on damaged or regenerating neuronal membranes." The book is available to read via the Internet as a limited preview.

For more information, google "valproic acid pain management." Hope this helps a bit!

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Valproic acid (theoretically) increases the level of GABA in the brain. Since GABA is an inhibitory neurotransmitter it may decrease pain signals in the central nervous system.

http://www.biopsychiatry.com/gaba/pain.html

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Specializes in Med/surg. ED. Palliative. Geront.

dont know for sure about valproiic acid, but I know that gabapentin is an anti seizure med used for pain control...maybe it's the same mechanism...

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Specializes in Med/surg. ED. Palliative. Geront.

here we go...wikipedia has this:

" It is more recently being used to treat neuropathic pain, as a second line agent, particularly lancinating pain from A* fibres. It is more recently being used to treat neuropathic pain, as a second line agent, particularly lancinating pain from A* fibres.'

http://en.wikipedia.org/wiki/Valproic_acid

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Many anti-epileptics, tri-cyclic antidepressants, and even some SSRI/SNRIs are starting to be used for neuropathic pain and fibromyalgia. What is your patient's diagnosis?

I think I've seen depakote used for neuropathy before--but I don't think it would be chosen first since it's an off label use. The TCAs, gabapentin, and Cymbalta are "indicated" in certain conditions, so may be easier to get paid for. But if you have a complicated pain patient for whom "indicated" meds aren't working, using a medication from the same or similar class is your next best bet.

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