The effect of gender differences on the use of valproic acid for migraine prophylaxis

Objective: To identify and evaluate the data regarding medication use for migraine prophylaxis in the pediatric population. Data Sources: Literature was obtained through searches in PubMed (Mid 1950s–March 2007), Iowa Drug Information Service/Web (1966–February 2007), International Pharmaceutical Abstracts (1970–Pebruary 2007), and the Cochrane Library. The terms migraine, prophylaxis, child, and children were used and cross referenced with all drug names. Reference citations from publications identified were also reviewed and included. Study Selection and Data Extraction: Only trials that evaluated migraine headaches in the pediatric population were included. Trials including adolescent and adult populations are briefly listed, but not reviewed. Trials involving nonprescription medication were also included in the evaluation. Due to the limited information, all clinical trials, retrospective reviews, and abstracts evaluated were included in this review. Data Synthesis: Few controlled clinical trials regarding prophylaxis therapy are available. Currently, no medications are approved by the Food and Drug Administration for prophylaxis of migraines in children. Seventeen drugs were identified and included in the review. Of the drugs with available data, topiramate, valproic acid, flunarizine, amitriptyline, and cyproheptadine have shown efficacy in decreasing migraine frequency and duration in children. However, larger clinical trials are necessary to validate the utility of these agents. Conflicting data exist for propranolol and pizotifen, and additional data are needed for gabapentin, leve-tiracetam, zonisamide, naproxen, and trazodone. In clinical trials, nimodipine, clonidine, and natural supplements have shown a lack of efficacy versus placebo for prophylaxis of migraines in children. Conclusions: Topiramate, valproic acid, and amitriptyline have the most data on their use for prophylaxis of migraines in children. Numerous agents have limited data in this population and several agents lack efficacy. Prospective, well designed, controlled clinical trials that include quality-of-life and functional outcomes are needed for guiding therapy of migraine prophylaxis for children.

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The incidence of adverse drug reactions in monotherapy of epilepsy with valproic acid: Gender differences

Journal of the Neurological Sciences ◽

10.1016/j.jns.2021.119155 ◽

2021 ◽

Vol 429 ◽

pp. 119155

Author(s):

Rimma Gamirova ◽

Roza Shajmardanova ◽

Elena Gorobets

Keyword(s):

Gender Differences ◽

Valproic Acid ◽

Adverse Drug Reactions ◽

Drug Reactions

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Valproic Acid Is Effective in Migraine Prophylaxis at Low Serum Levels: A Prospective Open-Label Study

Headache The Journal of Head and Face Pain ◽

10.1046/j.1526-4610.2001.01142.x ◽

2001 ◽

Vol 41 (8) ◽

pp. 774-778 ◽

Cited By ~ 18

Author(s):

Stephan Kinze ◽

Michael Clauss ◽

Uwe Reuter ◽

Tilo Wolf ◽

Jens Peter Dreier ◽

...

Keyword(s):

Valproic Acid ◽

Serum Levels ◽

Migraine Prophylaxis ◽

Open Label ◽

Open Label Study ◽

Label Study ◽

Low Serum

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Gender Related Changes in Gene Expression Induced by Valproic Acid in A Mouse Model of Autism and the Correction by S-adenosyl Methionine. Does It Explain the Gender Differences in Autistic Like Behavior?

International Journal of Molecular Sciences ◽

10.3390/ijms20215278 ◽

2019 ◽

Vol 20 (21) ◽

pp. 5278 ◽

Cited By ~ 5

Author(s):

Liza Weinstein-Fudim ◽

Zivanit Ergaz ◽

Gadi Turgeman ◽

Joseph Yanai ◽

Moshe Szyf ◽

...

Keyword(s):

Gene Expression ◽

Gender Differences ◽

Valproic Acid ◽

Prefrontal Cortex ◽

Mouse Model ◽

Behavioral Changes ◽

Male And Female ◽

Female Mice ◽

Adenosyl Methionine ◽

Males And Females

In previous studies we produced autism like behavioral changes in mice by Valproic acid (VPA) with significant differences between genders. S-adenosine methionine (SAM) prevented the autism like behavior in both genders. The expression of 770 genes of pathways involved in neurophysiology and neuropathology was studied in the prefrontal cortex of 60 days old male and female mice using the NanoString nCounter. In females, VPA induced statistically significant changes in the expression of 146 genes; 71 genes were upregulated and 75 downregulated. In males, VPA changed the expression of only 19 genes, 16 were upregulated and 3 downregulated. Eight genes were similarly changed in both genders. When considering only the genes that were changed by at least 50%, VPA changed the expression of 15 genes in females and 3 in males. Only Nts was similarly downregulated in both genders. SAM normalized the expression of most changed genes in both genders. We presume that genes that are involved in autism like behavior in our model were similarly changed in both genders and corrected by SAM. The behavioral and other differences between genders may be related to genes that were differently affected by VPA in males and females and/or differently affected by SAM.

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