Subcutaneous Levetiracetam and Sodium Valproate Use in Palliative Care Patients

Kondasinghe, Jayamangala Sampath; Look, Mei Ling; Moffat, Paula; Bradley, Keiron

doi:10.1080/15360288.2022.2107145

Cited by 5 publications

(6 citation statements)

References 15 publications

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“…There were three studies that described the use of subcutaneous sodium valproate for seizure control. Kondasinghe et al 9 describe the use of continuous subcutaneous infusions of sodium valproate in six patients (range 500 mg–2500 mg/24 h, median 1100 mg/24 h; see Table 2 ), in whom 5/6 (83%) had their seizures controlled. O’Connor et al describe seven patients in whom sodium valproate was used by continuous subcutaneous infusion as doses varying from 600 mg/24 h to 1200 mg/24 h. In this study 7/7 (100%) of patients achieved seizure control following initial dose adjustments.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies reported on the tolerability or adverse effects associated with subcutaneous sodium valproate. 9 , 12 , 14 , 15 The three of these studies that presented results on valproate in isolation, comprising a total of 19 patients receiving subcutaneous sodium valproate, reported one adverse effect. Kondasinghe et al 9 described one patient who experienced erythema at the subcutaneous line insertion site, which then resolved when a new subcutaneous access was obtained and the same concentration of sodium valproate provided subcutaneously at the second site.…”

Section: Resultsmentioning

confidence: 99%

“… 9 , 12 , 14 , 15 The three of these studies that presented results on valproate in isolation, comprising a total of 19 patients receiving subcutaneous sodium valproate, reported one adverse effect. Kondasinghe et al 9 described one patient who experienced erythema at the subcutaneous line insertion site, which then resolved when a new subcutaneous access was obtained and the same concentration of sodium valproate provided subcutaneously at the second site. One study reported on adverse effects in a cohort of patients receiving a diverse range of subcutaneous medications, which included a subset who were receiving subcutaneous valproate.…”

Section: Resultsmentioning

confidence: 99%

“… 7 Other reported administration routes include rectal and subcutaneous. 8 , 9 There are limited guidelines available regarding the possible use of subcutaneous sodium valproate.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Subcutaneous sodium valproate in palliative care: A systematic review

Tan,

Ng,

Tang

et al. 2024

Palliat Med

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Background: Seizures are an important palliative symptom, the management of which can be complicated by patients’ capacity to swallow oral medications. In this setting, and the wish to avoid intravenous access, subcutaneous infusions may be employed. Options for antiseizure medications that can be provided subcutaneously may be limited. Subcutaneous sodium valproate may be an additional management strategy. Aim: To evaluate the published experience of subcutaneous valproate use in palliative care, namely with respect to effectiveness and tolerability. Design: A systematic review was registered (PROSPERO CRD42023453427), conducted and reported according to PRISMA reporting guidelines. Data sources: The databases PubMed, EMBASE and Scopus were searched for publications until August 11, 2023. Results: The searches returned 429 results, of which six fulfilled inclusion criteria. Case series were the most common study design, and most studies included <10 individuals who received subcutaneous sodium valproate. There were three studies that presented results on the utility of subcutaneous sodium valproate for seizure control, which described it to be an effective strategy. One study also described it as an effective treatment for neuropathic pain. The doses were often based on presumed 1:1 oral to subcutaneous conversion ratios. Only one study described a local site adverse reaction, which resolved with a change of administration site. Conclusions: There are limited data on the use of subcutaneous sodium valproate in palliative care. However, palliative symptoms for which subcutaneous sodium valproate have been used successfully are seizures and neuropathic pain. The available data have described few adverse effects, supporting its use with an appropriate degree of caution.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“… 7 Other reported administration routes include rectal and subcutaneous. 8 , 9 There are limited guidelines available regarding the possible use of subcutaneous sodium valproate.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Subcutaneous sodium valproate in palliative care: A systematic review

Tan,

Ng,

Tang

et al. 2024

Palliat Med

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“…Taken together, the route of administration of antiseizure medication depends on the agent as well as the ease of use for patient, family, and caregivers ( Table 2 ). 59 60 61 62 63 64…”

Section: Epilepsy Management In the Setting Of Other Serious Illnessesmentioning

confidence: 99%

Emerging Trends in Neuropalliative Care: A Palliative Approach to Epilepsy and Seizure Management in Adults

Willert,

Kowski

2024

Semin Neurol

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Management of severe (drug-resistant) epilepsy and epilepsy in other serious illnesses is multidimensional and requires consideration of both physical symptoms and psychosocial distress that require individualized treatment. Palliative care offers a holistic approach to disease that focuses on all dimensions of suffering to maintain quality of life. Integration of a palliative care mind- and skillset in the management of severe epilepsy and epilepsy in other serious illnesses can provide person-centered care and support for families and caregivers.

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Levetiracetam/sodium-valproate

2023

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Subcutaneous Levetiracetam and Sodium Valproate Use in Palliative Care Patients

Cited by 5 publications

References 15 publications

Subcutaneous sodium valproate in palliative care: A systematic review

Subcutaneous sodium valproate in palliative care: A systematic review

Emerging Trends in Neuropalliative Care: A Palliative Approach to Epilepsy and Seizure Management in Adults

Levetiracetam/sodium-valproate

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