Comparison of Immediate vs Gradual Switch to Divalproex in Adults With Intellectual Disability
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Purpose
The purpose of this study is to determine whether there is any difference in side effects experienced by individuals with intellectual disorders taking Depakote DR (immediate release form) when they are switched to the extended release form (ER) overnight versus when they switch more gradually over a week.
| Condition | Intervention |
|---|---|
|
Epilepsy |
Drug: Divalproex |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Overnight Versus Progressive Conversion of Multiple Daily Dose Enteric-Coated Divalproex to Once-Daily Divalproex Extended Release: Which Strategy is Better Tolerated by Patients With Intellectual Disabilities? |
- direct observation of side effects by staff and investigator, side effect ratings using the MOSES side effect rating scale post-switch. (Multidimensional observational scale for elderly subjects) [ Time Frame: Baseline to day +8 ] [ Designated as safety issue: Yes ]
- seizures observed, compared with prior rate of seizures;maintenance of clinical response using the Clinical Global Impressions Scale-improvement subscale; [ Time Frame: Baseline to day + 8 ] [ Designated as safety issue: Yes ]
- total valproic acid serum levels (trough of pre-dose measurements) [ Time Frame: Prior to conversion, 1 week post conversion ] [ Designated as safety issue: Yes ]
- changes in blood work, including CBC, platelet counts, LFT, serum chemistry panel [ Time Frame: Prior to and one week post conversion ] [ Designated as safety issue: Yes ]
| Enrollment: | 18 |
| Study Start Date: | November 2006 |
| Study Completion Date: | December 2007 |
| Primary Completion Date: | December 2007 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 2
Slow Progressive Divalproex DR to Divalproex ER switch
|
Drug: Divalproex
Divalproex, 8-20% taper
Other Name: Depakote
|
|
Active Comparator: 1
Immediate, Progressive Divalproex DR to Divalproex ER switch
|
Drug: Divalproex
Divalproex, 8-20% taper
Other Name: Depakote
|
Detailed Description:
Considering that there are potential advantages to once-daily depakote extended release in terms of decreased side effects, decreased medication errors and patient compliance, there is a need to determine the best method of conversion from multiple-daily dose delayed release depakote to once-daily for subjects with epilepsy bipolar disorder or behavior disorders.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- patients currently taking divalproex direct release for any seizure and/or behavior disorder
- patients with intellectual disability
- other medications for co-morbid disease are permitted, provided no plans for changes in medication used for the treatment of the disorder are expected
Exclusion Criteria:
- patients with a recent history of status epilepticus in the past 6 months
- seizures in the past 3 months
- patients with acute illness requiring changes in concurrent drugs
- patients unwilling to change from their present direct release divalproex to divalproex extended release
- patients that do not have a reliable caregiver
- patients with lack of verbal expressive speech
Contacts and Locations| United States, Kansas | |
| University of Kansas Medical Center | |
| Kansas City, Kansas, United States, 66160 | |
| Principal Investigator: | Jessica Hellings, MD | University of Kansas |
More Information
No publications provided
| Responsible Party: | Jessica Hellings, MD, University of Kansas Medical Center |
| ClinicalTrials.gov Identifier: | NCT00347152 History of Changes |
| Other Study ID Numbers: | 10399 |
| Study First Received: | June 30, 2006 |
| Last Updated: | September 10, 2008 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by University of Kansas:
|
Intellectual disabilities development disabilities behavior disorders stable epilepsy |
Additional relevant MeSH terms:
|
Epilepsy Mental Retardation Brain Diseases Central Nervous System Diseases Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Signs and Symptoms Mental Disorders Diagnosed in Childhood Mental Disorders Valproic Acid Anticonvulsants |
Central Nervous System Agents Therapeutic Uses Pharmacologic Actions Enzyme Inhibitors Molecular Mechanisms of Pharmacological Action GABA Agents Neurotransmitter Agents Physiological Effects of Drugs Antimanic Agents Tranquilizing Agents Central Nervous System Depressants Psychotropic Drugs |
ClinicalTrials.gov processed this record on May 19, 2013