Phase III Double Blind Trial of Valproate Sodium for Prophylaxis of Post Traumatic Seizures
Information source: Office of Rare Diseases (ORD)
Information obtained from ClinicalTrials.gov on June 20, 2008
Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Post-Traumatic Seizure Disorder; Head Injuries
Intervention: phenytoin (Drug); valproate sodium (Drug)
Phase: Phase 3
Status: Completed
Sponsored by: National Institute of Neurological Disorders and Stroke (NINDS) Official(s) and/or principal investigator(s):
H. Richard Winn, Study Chair, Affiliation: Harborview Injury Prevention and Research Center
Summary
OBJECTIVES: I. Determine whether treating head injured patients with valproate sodium will
reduce the risk of developing seizures as a result of the head injury.
II. Determine the safety of valproate, the appropriate dose, and the effect valproate may
have on the recovery of the brain's ability to compute numbers, solve problems, remember
information, and control the movement of limbs after head injury.
Clinical Details
Study design: Treatment
Detailed description:
PROTOCOL OUTLINE: This is a randomized, double blind trial involving 3 treatment groups.
On day 1, controls receive phenytoin IV over 1 hour. On days 2 through 7, controls receive 2
doses each of phenytoin and placebo daily, intravenously. From day 8 through 6 months,
controls receive placebo IV 4 times daily, then placebo tablets are administered.
On day 1, the experimental group receives a loading dose of valproate sodium intravenously
over 1 hour within 24 hours of injury. Then, patients are divided into 2 subgroups.
From day 2 through 1 month, one group of patients receives valproate IV 4 times daily over 1
hour until tablets are tolerated. Patients receive placebo tablets by mouth 4 times daily
from month 2 through month 6.
On day 2, the other group of patients receives valproate IV 4 times daily and continues for 6
months until tablets (same dose) are tolerated.
If patients remain seizure free between day 8 and 6 months, the number of valproate or
placebo tablets are tapered over 1 week.
Each patient receives a full neuropsychological and psychosocial examination at 1, 6, and 12
months after injury.
Untreated observation of patients continues until 2 years after injury.
Eligibility
Minimum age: 14 Years.
Maximum age: N/A.
Gender(s): Both.
Criteria:
PROTOCOL ENTRY CRITERIA:
- -Disease Characteristics--
Any patient developing the following conditions within 24 hour postinjury:
- Cortical contusion
- Depressed skull fracture
- Subdural hematoma
- Epidural hematoma
- Intracerebral hematoma
- Penetrating head wound
- Seizures occurring subsequent to head injury
- -Prior/Concurrent Therapy--
- No antiseizure medication prior to injury or between the injury and study drug
loading
- Surgery: No prior neurosurgical operation for which the skull and dura mater were
opened
- -Patient Characteristics--
- Age: 14 and over
- Hematopoietic: No abnormal coagulation profile
- Hepatic: No history of chronic or alcoholic liver disease Adequate liver function as
indicated by ALT less than 1. 5 times the upper limit of normal
- Other: Not pregnant No injuries greater than 24 hours old No history of seizures prior
to injury No prior history of significant head injury or neurological condition
requiring medical attention
Locations and Contacts
Additional Information
Starting date: February 1991
Last updated: June 23, 2005
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