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Valproate sodium (Depacon) and divalproex sodium (Depakote ER) are antiepileptic drugs evaluated by Thomas Jefferson University for the treatment of cluster headaches. The regimen involves consecutive daily intravenous doses of Depacon followed by or in combination with oral Depakote ER during a cluster headache cycle. Valproate is thought to work by increasing gamma-aminobutyric acid (GABA) levels in the brain and modulating neuronal excitability through the blockade of voltage-gated sodium channels and T-type calcium channels. While divalproex sodium is FDA-approved for migraine prophylaxis, its use in cluster headache remains off-label and experimental.
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