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The Diamond Headache Clinic first began using valproic acid in 1984. Subsequently, a variety of open-label and then placebo-controlled trials were carried out with valproic acid, followed by an enteric-coated formulation known as divalproex sodium delayed-release. These trials demonstrated a consistent pattern of efficacy and the delayed-release form improved tolerability while offering a twice-daily dosing schedule. This led to the development of an extended-release formulation. This formulation further improved tolerability and led to a once-daily dosing. The pivotal trial conducted in patients with migraine with the extended-release formulation demonstrated efficacy similar to that seen with the delayed-release form.
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Fred Freitag (2003) studied this question.
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