Therapeutic targets
- Pain relief
- Treatment of cerebral edema
- Treatment of symptoms:
- Epilepsy (seizures) → antiepileptic drugs.
Therapy recommendations
- For cerebral edema:
- Dexamethasone (glucocorticoids), first-line agent.
- For acute treatment of severe cerebral edema: osmodiuretics (drugs with a dehydrating effect).
- Mannitoline infusions (20%, maximum 6 x 250 ml/day).
- Analgesia according to WHO staging scheme (see under “Chronic pain”):
- Non-opioid analgesic (paracetamol, acetaminophen, first-line agent for headache; alternatively, indomethacin has an analgesic effect as well as an effect on intracranial pressure)).
- Low-potency opioid analgesic (eg, tramadol) + non-opioid analgesic.
- High-potency opioid analgesic (eg, morphine) + non-opioid analgesic.
- In the context of chemotherapy, the drug hydroxyurea can be used. However, no clear benefit has been demonstrated so far.
Notice:
- Taking valproic acid during pregnancy will harm the child’s intelligence in the long term.
- Red-hand letter (AkdÄ Drug Safety Mail): contraindications, warnings, and measures to avoid exposure to valproate during pregnancy:
- In girls and women of childbearing age, valproate should be used only if other treatments are not effective or are not tolerated.
- Valproate is contraindicated in women of childbearing age unless the pregnancy prevention program is followed.
- Valproate is contraindicated in epilepsy during pregnancy unless no suitable alternatives are available.
- Valproate is contraindicated during pregnancy for bipolar disorder and migraine prophylaxis.
