Valproic acid for pain? Really?

miss81, BSN, RN · Sep 8, 2009

GABA can mediate the transmission and perception of pain. Pain control could be related to the fact that valporic acid increases brain concentrations of gamma-aminobutyric acid (GABA). The effect on the neuronal membrane is still unknown. So for that reason and because of the sedative side effects of valporic acid it has not been widely used for pain control. But it does makes sense why it could be used for pain control. I have seen it used for migraines and depression related pain.

firefox828 · Sep 8, 2009

MDs in our hospital have been prescribing this IV/PO to pts. with severe headace/migraine. I questioned this too, initially.

iteachob, MSN, RN · Sep 8, 2009

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.

Yes. Used frequently to treat trigeminal neuralgia.

RNBearColumbus, BSN · Sep 8, 2009

Heh.

All I can come up with is that since valproic acid targets a specific neurotransmitter (GABA) it might (And I think it's a stretch...) be used for pain associated with neuropathy. It's also used for the prevention of migraines.

Of course, the cynic in me wonders if someone there is using it to medicate behaviors without having to jump through all of the extra hoops required when prescribing a psychoactive drug. ( "No Mr. State Health Department Investigator, we aren't giving Bob that Depakote because he's an annoying demntia patient with behaviors , we're giving it to him for pain...Honest!" ) :smokin:

mcleanl · Sep 8, 2009

http://www.cancer.org/docroot/CDG/content/CDG_valproic_acid.asp

mindlor · Sep 8, 2009

Maybe I am confused?

Are you a doc or mid-level provider?

Otherwise RN and below we give what is ordered no?

Also I am sure things vary State by State.......

PAERRN20 · Sep 8, 2009

Maybe I am confused?
Are you a doc or mid-level provider?
Otherwise RN and below we give what is ordered no?
Also I am sure things vary State by State.......

I believe the original poster was questioning an order written by a MD/mid-level. This is within the RN scope and very appropriate.

iteachob, MSN, RN · Sep 8, 2009

Maybe I am confused?
Are you a doc or mid-level provider?
Otherwise RN and below we give what is ordered no?
Also I am sure things vary State by State.......

It's good practice to know how and why any medication you give works (for pain, or whatever). Not good practice to blindly give what is ordered without knowing.

sethmctenn · Sep 8, 2009

We have a few docs in our area who use Depakote for pain, especially back pain. Most are neurologists. My mother is on it for bipolar disorder. She also has bulging lumbar discs. Whenever she goes off it (as most bipolars like to do from time to time), her pain increases.

miss81, BSN, RN · Sep 8, 2009

Maybe I am confused?
Are you a doc or mid-level provider?
Otherwise RN and below we give what is ordered no?
Also I am sure things vary State by State.......

Well we don't just give it because it was ordered... we are allowed to use our judgement and question something if we do not believe it is appropriate. I'm not sure if that was exactly what you were asking??

morte, LPN, LVN · Sep 8, 2009

Maybe I am confused?
Are you a doc or mid-level provider?
Otherwise RN and below we give what is ordered no?
Also I am sure things vary State by State.......

to whom are you addressing this?

kanzi monkey · Sep 9, 2009

Maybe I am confused?
Are you a doc or mid-level provider?
Otherwise RN and below we give what is ordered no?
Also I am sure things vary State by State.......

The OP is an ANP (says in his bio)--so he's likely a prescriber. But I agree with the other posters as well--RNs are responsible for understanding what they're giving and why.