Sb. Zachariah et al., POSITIVE RESPONSE TO ORAL DIVALPROEX SODIUM (DEPAKOTE) IN PATIENTS WITH SPASTICITY AND PAIN, The American journal of the medical sciences, 308(1), 1994, pp. 38-40
Divalproex sodium (DVS; Depakote) is a commonly used antiepileptic age
nt that increases the levels of gamma aminobutyric acid. Spasticity fr
om different causes may be due to a deficiency of inhibitory transmitt
ers like gamma aminobutyric acid or an excess of excitatory neurotrans
mitters. Spasticity also may be accompanied by pain. The authors admin
istered DVS orally for pain and spasticity in three patients with a hi
story of spinal cord injury and one patient with a history of head inj
ury. Three patients had marked improvement in spasticity and pain. One
patient, who had some symptomatic improvement in spasticity, could no
t tolerate DVS because of gastric irritation. In contrast to the side
effects of sedation and increased motor weakness associated with antis
pasticity drugs commonly used, no such side effects were detected with
DVS. It is suggested that a possible enhancement by DVS of gamma amin
obutyric acid-ergic postsynaptic inhibition of motor reflex are in the
spinal cord may represent a new nonsedating, management approach for
spasticity as a result of traumatic spinal cord and head injuries.