Extended‐Release Divalproex Sodium for Mood Stabilization

Stoner, Steven C.; Dubisar, Beth; Lea, Jessica W.; Marken, Patricia A.; Ramlatchman, Leonard V.; Reynolds, James B.

doi:10.1592/phco.24.13.1147.38088

Cited by 6 publications

(2 citation statements)

References 22 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, we compared the AEs between the VPA-ER and VPA-DR groups. It has been reported that extended-release divalproex sodium can reduce the incidence of AEs associated with divalproex sodium ( Stoner et al, 2004 ), and another retrospective study also reported fewer AEs in patients taking the divalproex ER formulation ( Minirth and Neal, 2005 ). Here, we obtained a consistent finding that the incidence of AEs was slightly lower in VPA-ER than in VPA-DR.…”

Section: Discussionmentioning

confidence: 99%

Efficacy, Safety, and Retention Rate of Extended-Release Divalproex Versus Conventional Delayed-Release Divalproex: A Meta-Analysis of Controlled Clinical Trials

Zhang¹,

Li²,

Wan³

et al. 2022

Front. Pharmacol.

View full text Add to dashboard Cite

Purpose: A novel once-daily divalproex-extended release (ER) dose formulation has been developed; this formulation prolongs the therapeutic serum levels of the drug, compared with the twice-daily conventional divalproex-delayed release (DR) formulation. This study aimed to systematically examine and compare the efficacy, safety, and retention rates of the ER divalproex (VPA-ER) and conventional DR divalproex (VPA-DR) formulations.Methods: Randomized control trials (RCTs) reporting the efficacy, adverse events (AEs), and medication compliance of ER and DR divalproex were searched in online databases, including PubMed, Embase, and Cochrane Library databases, by searching MeSH words and term words. Observational studies with potential biases were excluded. The meta-analysis was performed using Stata 16.0 software.Findings: Thirteen RCTs, involving 1,028 participants, were included in this meta-analysis. Efficacy, AEs, and drug retention rates were the main study outcomes. According to our study, VPA-ER presented clinically significant benefits compared with the placebo in the population with bipolar disorder (BD) (39.5% versus 27.2%, p < 0.001). A similar efficacy of VPA-ER and VPA-DR in controlling seizures was observed in epilepsy patients (87.4% versus 86.5%, p = 0.769). A significantly lower incidence of AEs was reported in the VPA-ER group than in the placebo group (26.8% versus 34.8%, p = 0.003). By contrast, there was no evidence of difference in safety between VPA-ER and VPA-DR (29.4% versus 30.5%, p = 0.750). In addition, the drug retention rate was significantly lower in the VPA-ER group than in the placebo group (76.0% versus 82.7%, p = 0.020), especially in migraine patients (p = 0.022) and in patients who were treated for fewer than 4 weeks (p = 0.018).Implications: The efficacy of VPA-ER was significantly superior to that of the placebo treatment, which provided efficacy similar to that of conventional VPA-DR. VPA-ER is well tolerated with a low rate of AEs compared to the placebo. In addition, the acceptable medicine compliance of VPA-ER was conducive to the long-term maintenance treatment of chronic diseases. Although we analyzed open labels and crossover design RCTs, large-scale multicenter studies on the efficacy and medicine compliance of new ER formulations with less AEs are required to validate our conclusion.

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy, Safety, and Retention Rate of Extended-Release Divalproex Versus Conventional Delayed-Release Divalproex: A Meta-Analysis of Controlled Clinical Trials

Zhang¹,

Li²,

Wan³

et al. 2022

Front. Pharmacol.

View full text Add to dashboard Cite

show abstract

“…A second published, open-label study highlighted the conversion of DR to ER in ten subjects over a four-week time period (Stoner et al 2004). Subjects were deemed eligible if they had been on DR at least 8 weeks and were considered “stable” in the two weeks preceding study enrollment.…”

Section: Clinical Trials – Efficacymentioning

confidence: 99%

Extended-release divalproex in bipolar and other psychiatric disorders: A comprehensive review

Stoner¹

2008

NDT

View full text Add to dashboard Cite

Bipolar disorder can be a devastating disease state for individuals with the disease and also for family members. Proper recognition and treatment is vital to the successful management of this disease state. Through increased community and practitioner awareness, along with efforts to increase awareness for proper assessment, the rate of diagnosed bipolar disorder is increasing. Recent years have brought about the introduction of several new medications with approved indications for the treatment of bipolar disorder. In addition to new agents, traditional mood stabilizing medications have also been released in different formulations to better enhance tolerability without jeopardizing effi cacy. One particular product is extended-release divalproex sodium. In the following article, we review the clinical presentation of bipolar disorder, its epidemiology, and the pharmacokinetics and mechanism of action for divalproex. In addition, we specifi cally review the role of extended-release divalproex in bipolar disorder through a critical analysis of the currently available published primary literature.

show abstract

Current awareness in human psychopharmacology

2005

Hum. Psychopharmacol. Clin. Exp.

View full text Add to dashboard Cite

Extended‐Release Divalproex Sodium for Mood Stabilization

Cited by 6 publications

References 22 publications

Efficacy, Safety, and Retention Rate of Extended-Release Divalproex Versus Conventional Delayed-Release Divalproex: A Meta-Analysis of Controlled Clinical Trials

Efficacy, Safety, and Retention Rate of Extended-Release Divalproex Versus Conventional Delayed-Release Divalproex: A Meta-Analysis of Controlled Clinical Trials

Extended-release divalproex in bipolar and other psychiatric disorders: A comprehensive review

Current awareness in human psychopharmacology

Contact Info

Product

Resources

About