HER2 Support Group Forums - View Single Post - for those facing whole brain radiation 4 brain mets--Antiepileptic drug use improves

donocco · 10-24-2015, 09:42 PM

Lani

Interesting. The thought of using Valproate to prevent or treat brain mets has been in my head for years. It is a strong Histone Deacetylase inhibitor and penetrates the brain well. I thought it was just a theoretical idea in my head although I assumed others have thought of it too.

Paula (God rest her Soul) sent me a bunch of private messages to pick my brain as far as treatment. I certainly didnt argue with intrathecal Herceptin but I suggested Valproate to her as add on because of its Histone Deacetylase inhibiting action and because of its brain penetration. I have no idea if it was used. It may have been too late in the game. Or if the doctor agreed as it is not standard treatment.

I dont know if Depakote (Valproate) is an anti-siezure drug that is useful for treating say Taxol neuropathy (or Ixabepalone neuropathy-whatever) but if it is, why not use Depakote instead of say Neurontin because of it histone deacetylase action. If you read the side effects, hair loss, pancreatitis and hepatitis are mentioned but it is basically a relatively safe drug.

It has a unique action in epilepsy. It is useful for both grand mal and petit mal. When I went to pharmacy school the general rule about anti-siezure drugs was that drugs useful for grand mal (dilantin) will make petit mal worse and drugs useful for petit mal (Trimethadione) will aggravate grand mal.

This was a real problem treating children with petit mal because about 25% of them develop grand mal in adolescence. Some of the grand mal was thought to be due to activation of the grand mal tendency by the petit mal drugs.

When Depakote was approved, the problem was kind of over. Neurologists now had an anticonvulsant that was beneficial for both petit mal and grand mal. Because of this depakote has been extensively used and there is a lot of clinical experience with it. All drugs can have bad side effects but depakote is relatively safe.

Brain mets are a real problem with Her2Neu breast cancers and its possible that Depakote could be a partial answer. It could theoretically have some value in prophylaxis. Ill research the drug to see if it can benefit chemo induced neuropathies.

Paul

10-24-2015, 09:42 PM	#2
donocco Senior Member Join Date: Oct 2013 Posts: 474	Re: for those facing whole brain radiation 4 brain mets--Antiepileptic drug use impro Lani Interesting. The thought of using Valproate to prevent or treat brain mets has been in my head for years. It is a strong Histone Deacetylase inhibitor and penetrates the brain well. I thought it was just a theoretical idea in my head although I assumed others have thought of it too. Paula (God rest her Soul) sent me a bunch of private messages to pick my brain as far as treatment. I certainly didnt argue with intrathecal Herceptin but I suggested Valproate to her as add on because of its Histone Deacetylase inhibiting action and because of its brain penetration. I have no idea if it was used. It may have been too late in the game. Or if the doctor agreed as it is not standard treatment. I dont know if Depakote (Valproate) is an anti-siezure drug that is useful for treating say Taxol neuropathy (or Ixabepalone neuropathy-whatever) but if it is, why not use Depakote instead of say Neurontin because of it histone deacetylase action. If you read the side effects, hair loss, pancreatitis and hepatitis are mentioned but it is basically a relatively safe drug. It has a unique action in epilepsy. It is useful for both grand mal and petit mal. When I went to pharmacy school the general rule about anti-siezure drugs was that drugs useful for grand mal (dilantin) will make petit mal worse and drugs useful for petit mal (Trimethadione) will aggravate grand mal. This was a real problem treating children with petit mal because about 25% of them develop grand mal in adolescence. Some of the grand mal was thought to be due to activation of the grand mal tendency by the petit mal drugs. When Depakote was approved, the problem was kind of over. Neurologists now had an anticonvulsant that was beneficial for both petit mal and grand mal. Because of this depakote has been extensively used and there is a lot of clinical experience with it. All drugs can have bad side effects but depakote is relatively safe. Brain mets are a real problem with Her2Neu breast cancers and its possible that Depakote could be a partial answer. It could theoretically have some value in prophylaxis. Ill research the drug to see if it can benefit chemo induced neuropathies. Paul