Expert Answer: Depakote for Migraine Treatment
Please read important information regarding the FDA warning for Depakote and other Valrpoate medications during pregnancy.
Question:How is Depakote used to abort Migraines?
Depakote (generic name Divalproex) is a medication used for Migraine, but it is not typically used for aborting (ending) an attack, though it can be. Instead, it's ordinarily used to try to prevent attacks from occurring or reduce their frequency and/or intensity. It is FDA approved for this purpose in Migraine patients. However, it is also sometimes used intravenously (IV) in an office or emergency setting for treatment of an acute attack (IV form called Depacon).
Divalproex falls into a category of medications called anticonvulsants or antiseizure drugs. These medications are used to treat a variety of neurological diseases (epilepsy and Migraine) and psychiatric conditions (bipolar disorder). Topamax (generic name topamirate), another medication FDA approved for Migraine prevention, is also an anticonvulsant.
Intravenous use of Divalproex for treatment of an acute attack has been shown effective in some research studies. In one study conducted in 2000, half of patients (16 of 32 people) treated with IV Divalproex for an acute attack experienced mild or moderate (25-80%) relief within 3 hours.
Like all medications currently used for Migraine prevention, Divalproex was not developed to treat Migraine Disease specifically. But as researchers noticed that patients using it for other conditions experienced fewer Migraine attacks, they began to study it for use in Migraine patients.
Experts aren't sure how Divalproex works to prevent or treat Migraine attacks in the patients who are helped by it. As more is understood about the pathophysiology (functional changes arising out of the disease process) of Migraine Disease we will have an increasingly better understanding about how all the medications used for aborting, treating our symptoms and preventing Migraine attacks work.
For more information about lesser-known treatment options for acute attacks please read Ellen's piece: How to Treat Migraines without Triptans or Ergotamines.
For more information about preventive options please read Teri's article: Migraine Management Essential 4: Preventive Treatment.
Can you tell when a migraine attack is coming?