Divalproex Sodium Versus Valproic Acid in Hospital Treatment of Psychotic Disorders

Schwartz, Thomas L.; Massa, José Luis Pedreira; Gupta, Sanjay; Al-Samarrai, Sadiq; Devitt, Patrick J; Masand, Prakash S.

doi:10.4088/pcc.v02n0203

Cited by 13 publications

(22 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Increased rates of gastrointestinal side effects with generic valproic acid have been described [32–35]. One case report [36] found decreased platelets following a switch from divalproex sodium to valproic acid, normalizing after switch‐back to divalproex sodium.…”

Section: Substitution Of Psychotropicsmentioning

confidence: 99%

“…Both medications were equally efficacious but carried different rates of gastrointestinal side effects; 14.7% for divalproex sodium and 28.7% for valproic acid. A chart review of 28 patients with psychotic disorders switched from divalproex sodium to valproic acid did not show a difference in effectiveness [35]. Valproic acid was, however, prescribed at higher doses and was associated with more gastrointestinal side effects.…”

Section: Substitution Of Psychotropicsmentioning

confidence: 99%

See 1 more Smart Citation

Switching from Brand‐Name to Generic Psychotropic Medications: A Literature Review

Desmarais

Beauclair

Margolese

2010

CNS Neuroscience & Therapeutics

View full text Add to dashboard Cite

Generic medications do not undergo the rigorous approval process required of original medications. Their effectiveness and safety is expected to be equal to that of their more expensive counterparts. However, several case reports and studies describe clinical deterioration and decreased tolerability with generic substitution. Pubmed was searched from January 1, 1974 to March 1, 2010. The MeSH term "generic, drugs" was combined with "anticonvulsants," "mood stabilizers," "lithium," "antidepressants," "antipsychotics," "anxiolytics," and "benzodiazepines." Additional articles were obtained by searching the bibliographies of relevant references. Articles in English, French, or Spanish were considered if they discussed clinical equivalence of generic and brand-name medications, generic substitution, or issues about effectiveness, tolerability, compliance, or economics encountered with generics. Clinical deterioration, adverse effects, and changes in pharmacokinetics are described with generic substitution of several anticonvulsants/mood stabilizers (carbamazepine, valproate, lamotrigine, gabapentin, topiramate, lithium), antidepressants (amitriptyline, nortriptyline, desipramine, fluoxetine, paroxetine, citalopram, sertraline, venlafaxine, mirtazapine, bupropion), antipsychotics (risperidone, clozapine), and anxiolytics (clonazepam, alprazolam). Generics do not always lead to the anticipated monetary savings and also raise compliance issues. Although the review is limited by publication bias and heterogeneity of the studies in the literature, we believe there is enough concern to advise generic switching on an individual basis with close monitoring throughout the transition. Health professionals should be aware of the stakes around generic substitution especially when health economics promote universal use of generics.

show abstract

Section: Substitution Of Psychotropicsmentioning

confidence: 99%

Section: Substitution Of Psychotropicsmentioning

confidence: 99%

Switching from Brand‐Name to Generic Psychotropic Medications: A Literature Review

Desmarais

Beauclair

Margolese

2010

CNS Neuroscience & Therapeutics

View full text Add to dashboard Cite

show abstract

“…Among them, VA, a widely used in clinical practice as first-line antiepileptic drug, has been revealed to induce neurogenesis of stem cells. 14 In the current study, rMDSCs were used as model cells to investigate the potential of VA to induce neurogenesis. It has been reported that VA treatment might be cytotoxic to rMDSCs.…”

Section: Discussionmentioning

confidence: 99%

Neural differentiation of rat muscle-derived stem cells in the presence of valproic acid: A preliminary study

Kwon

Kim

et al. 2012

Tissue Eng Regen Med

View full text Add to dashboard Cite

In this study, we chose valproic acid (VA) for inducing neural differentiation in rat muscle-derived stem cells (rMDSCs). After pre-induction with basic fibroblast growth factor (bFGF) and subsequent treatment with VA, VA-related cytotoxicity to rMDSCs was relatively low. In addition, VA-treated rMDSCs exhibited a neural-like morphology after 1, 4, and 7 days. The immunocytochemical results of VA-treated rMDSCs showed abundant cells stained positive for neuron-specific enolase (NSE) and neuron filament (NF) as neural markers, oligodendrocyte transcription factor 2 (Olig-2) as an oligodendrocyte marker, and glial fibrillary acidic protein (GFAP) as an astrocyte marker. Our results suggest that rMDSCs can be differentiated into a neural-like phenotype by using VA.

show abstract

“…The issue represents the tradeoffs between extra costs and the corresponding additional health benefits gained by the use of the brand drug. In recent years, a limited number of small studies have compared the two formulations in various mental health settings and shown consistent results in favour of valproic acid as being medically and economically comparable or superior to divalproex sodium (8, 9, 12, 13). However, the strongest evidence comes from a recently published 6‐year prospective clinical trial that compared the effectiveness of divalproex sodium with valproic acid in 9260 psychiatric admissions (14).…”

Section: Discussionmentioning

confidence: 99%

“…A number of small studies comparing the two formulations have reported a significantly higher incidence of gastrointestinal side‐effects with valproic acid as compared to divalproex sodium (5–7). However, the side‐effects tend to be mostly transient, are easily treatable and may not translate into significantly higher health resource utilization (8–10). Conversely, the generic substitution of valproic acid for divalproex sodium has the potential to result in substantial cost savings to the healthcare systems.…”

Section: Introductionmentioning

confidence: 99%

Divalproex sodium vs. valproic acid: drug utilization patterns, persistence rates and predictors of hospitalization among VA patients diagnosed with bipolar disorder

Iqbal

Cunningham²,

Lee

et al. 2007

J Clin Pharm Ther

View full text Add to dashboard Cite

show abstract

Divalproex Sodium Versus Valproic Acid in Hospital Treatment of Psychotic Disorders

Cited by 13 publications

References 3 publications

Switching from Brand‐Name to Generic Psychotropic Medications: A Literature Review

Switching from Brand‐Name to Generic Psychotropic Medications: A Literature Review

Neural differentiation of rat muscle-derived stem cells in the presence of valproic acid: A preliminary study

Divalproex sodium vs. valproic acid: drug utilization patterns, persistence rates and predictors of hospitalization among VA patients diagnosed with bipolar disorder

Contact Info

Product

Resources

About