Subcutaneous sodium valproate in palliative care: A systematic review

This episode features Sheryn Tan (University of Adelaide, Adelaide, SA, Australia) and Dr Stephen Bacchi (Flinders University, Bedford Park, SA, Australia; Lyell McEwin Hospital, Elizabeth Vale, SA, Australia)

What is already known about the topic?

• In palliative care patients for whom there is a need for non-oral antiseizure medications, and a preference to avoid intravenous access, options are primarily limited to benzodiazepines.
• In circumstances where the sedative effects of benzodiazepines are to be avoided, the use of subcutaneous levetiracetam have been reported.
• There are limited guidelines available regarding the possible use of subcutaneous sodium valproate.

What this paper adds?

• Several studies have described successful use of subcutaneous sodium valproate in palliative care to manage seizures.
• While limited, the available data described few adverse effects, aside from an isolated local reaction that is resolved with a change of site.
• Current routine medication resources may not reflect this potential use of sodium valproate, and palliative care has unique medication considerations that may not apply to medication administration in other settings.

Implications for practice, theory, or policy

• Although data are limited, existing studies present enough evidence to argue for the inclusion of subcutaneous valproate in the palliative care armamentarium for selected circumstances.

Full paper available from:    

https://journals.sagepub.com/doi/10.1177/02692163241234597

If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: 

a.nwosu@lancaster.ac.uk