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valproate semisodium (Depakote ER / divalproex ER)

✓ Approved

AbbVie, Inc. · SCN1A · Small Molecule

What is valproate semisodium?

valproate semisodium is a small molecule developed by AbbVie, Inc.. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand NamesDepakote ER, divalproex ER
CompanyAbbVie, Inc.
Drug ClassSmall Molecule
Molecular TargetSCN1A, SCN2A, SCN3A
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, AbbVie, Inc.

Mechanism of Action

Molecular Targets

valproate semisodium acts on 3 molecular targets:

SCN1Asodium voltage-gated channel alpha subunit 1 (DEE6B, FEB3)
SCN2Asodium voltage-gated channel alpha subunit 2 (Na(v)1.2, BFNIS)
SCN3Asodium voltage-gated channel alpha subunit 3 (Nav1.3, NAC3)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

valproate semisodium is developed for 3 unique indications across 3 therapeutic areas.

Therapeutic AreaConditionPhase
Nervous system disordersGeneralised tonic-clonic seizure✓ Approved
Psychiatric disordersBipolar disorder✓ Approved
Surgical and medical proceduresMigraine prophylaxis✓ Approved

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Advances in endoplasmic reticulum autophagy and its role in viral infection.

He Yulin Y, Su Yaxing Y, Xu Qing Q, Bian Zhibiao Z et al.

Endoplasmic reticulum autophagy (ER-phagy) is an emerging form of selective autophagy that maintains ER homeostasis by selectively delivering ER components to lysosomes for degradation. Increasing evidence indicates that ER-phagy is closely involved in immune regulation, particularly in the context of viral infection, where it influences host antiviral defenses and virus-host interactions. In this review, we summarize recent advances in ER-phagy research, focusing on the identified mammalian ER-phagy receptors, their molecular characteristics, and their roles in maintaining ER function. Furthermore, we discuss the bidirectional interplay between ER-phagy and viral infections, including how ER-phagy contributes to innate immune responses through the regulation of antiviral signaling pathways, and how viruses manipulate ER-phagy machinery to promote their replication or evade host immunity. By highlighting the immunological significance of ER-phagy in virus-host interactions, this review provides new perspectives on the role of ER quality control mechanisms in antiviral immunity and their potential implications for the development of antiviral strategies.

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Peritoneal carcinomatosis and bowel obstruction as an unusual presentation of metastatic breast carcinoma.

Sawas Abu-Amin Jamil J, Carrero Castaño Alejandro A, Romo Navarro Ángel Á, Parra Tercero Ana Rosa AR

Peritoneal metastasis from breast carcinoma is uncommon and is more frequently associated with invasive lobular carcinoma than with invasive carcinoma of no special type (NST). We report a 58-year-old woman with a history of invasive breast carcinoma NST who developed peritoneal carcinomatosis causing malignant bowel obstruction several years after metastatic recurrence. Surgical specimens showed metastatic carcinoma with an immunophenotypic profile strongly supporting mammary origin, including expression of GATA3, GCDFP-15, CK7, E-cadherin and CK19. The peritoneal metastasis was ER-negative, PR-negative and HER2 non-amplified, contrasting with a previously sampled ER-positive metastatic lesion. This case highlights the diagnostic challenge of peritoneal carcinomatosis in patients with a remote history of breast cancer, the clinical relevance of receptor discordance during metastatic progression, and the importance of reassessing biomarker status in metastatic lesions when feasible.

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PubMedFrontiers in pediatrics2026-11-12

The golden hour: the feasibility of a quality improvement project to decrease the time to antibiotic administration in children with cancer and febrile neutropenia in Jordan.

Halalsheh Hadeel H, Abu Alrub Ghada G, Kallab Islam I, Al-Shawabkeh Nimeh N et al.

Febrile neutropenia (FN) is a potentially life-threatening condition in pediatric oncology; early antibiotic initiation is associated with improved survival. A quality improvement (QI) project was implemented in the Pediatric Emergency Room (ER) to improve the timeliness of antibiotic administration. Starting in July 2019, the project was designed using the Find, Organize, Clarify, Understand, and Select-Plan, Do, Check, and Act (FOCUS-PDCA) framework. We aimed to give antibiotics within 60 min of ER arrival for children with suspected FN. High-risk patients received antibiotics without waiting for blood count confirmation. A structured staff education campaign was conducted over 6 months, and performance metrics were continuously monitored. Outcomes were compared with retrospective data from December 2018 to June 2019. The pre-intervention cohort included 119 children with cancer, accounting for 158 FN episodes. From July 2019 to December 2024, during the intervention period, 697 children with cancer (median age 4.7 years; IQR 2.6-9.2 years; 54% male) presented with FN, accounting for 1,164 ER visits (median 1 visit/patient; range, 1-11). The median absolute neutrophil count (ANC) at presentation was 50 cells/μL (IQR, 0-180 cells/μL). Median time from ER arrival to antibiotic administration decreased from 120 min (IQR, 97-143) at pre-intervention baseline to 50 min (IQR, 40-65) across the implementation period (p < 0.01). The time from antibiotic ordering to first dose remained stable (median 32 min; IQR, 25-40), while time from arrival to antibiotic ordering decreased from 53 to 15 min (p < 0.01). Compliance with the 60 min target improved from 22% in the pre-intervention period to a sustained 85%-90% range across 2021-2024, with the ≥90% target met in all 12 months of 2021 and compliance declining to 85.8% in 2024. The target was increased to 90% in September 2020. A structured Golden Hour QI initiative is feasible, effective, and associated with substantial and sustained improvement in antibiotic timeliness in the Middle East region, without additional funding, staffing, or technology. The core drivers of sustained improvement were automatic Category-A triage for children with cancer presenting with fever, pre-ANC antibiotic initiation for high-risk cases, and monthly audit-feedback cycles - all implementable within existing workflows.

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Fluorine-Functionalized Isophorone Near-Infrared Cu2+ Fluorescent Probe for Lung-Targeted Imaging of Diabetic Lung Injury and Lung Cancer.

Shao Jinping J, An Xiaotong X, Zhang Cong C, Huang Yani Y et al.

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Do Golgi-mitochondria membrane contact sites regulate lipid flux and local apoptotic fate decisions?

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Membrane contact sites (MCSs) between intracellular organelles serve as vital platforms for non-vesicular lipid transfer and metabolic signaling, challenging traditional views of organellar autonomy. While endoplasmic reticulum (ER)-mediated junctions such as mitochondria-associated ER membranes (MAMs) have been extensively characterized, the interface between the Golgi apparatus and mitochondria (Golgi-mitochondria contact sites, or GMCs) remains less defined despite its strategic biochemical position. The Golgi complex acts as the principal hub for sphingolipid modification and phosphoinositide sorting, whereas mitochondria rely on imported lipid species to maintain structural integrity and govern cell death cascades. This review synthesizes current evidence regarding the molecular architecture, lipid transport dynamics, and apoptotic regulatory roles of GMCs. We evaluate proposed tethering mechanisms, distinguishing between established yeast pathways (such as the Snf1-dependent Vps53 axis) and unvalidated mammalian hypotheses (including potential AMPK regulation). Furthermore, we treat GDAP1 as a contact-site modulator rather than a confirmed physical tether, and discuss how non-vesicular fluxes of ceramide, phosphatidylinositol-4-phosphate (PI(4)P), and cholesterol alter outer mitochondrial membrane dynamics.

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PubMedFrontiers in neurology2026-11-12

Redefining drug-induced tremor: a mechanism-based framework for clinical and etiological assessment.

Shin Hae-Won HW

Drug-induced tremor (DIT) encompasses clinically diverse syndromes with different mechanisms, clinical courses, and management needs. This Perspective proposes a mechanism-based approach to guide evaluation and management by integrating tremor phenotype, drug pharmacology, associated neurological findings, and clinical course. The initial assessment considers peripheral adrenergic amplification, dopamine receptor blockade or depletion, and systemic or neurotoxic effects, while allowing drug-specific assessment when mechanisms are less clearly understood, as with valproate and serotonergic antidepressants. These considerations guide treatment adjustment and targeted investigation. Associated cerebellar, neuropathic, cognitive, or systemic findings guide evaluation for neurotoxicity and metabolic abnormalities. When tremor is accompanied by parkinsonian features, clinical follow-up assesses recovery, persistence, or progression. Dopamine transporter (DAT) imaging is considered when uncertainty about coexisting nigrostriatal degeneration would affect management. Assessment also considers tardive tremor, taking into account its clinical features and the timing of symptoms in relation to prolonged drug exposure and withdrawal. By connecting these assessments to investigation, treatment, follow-up, and counseling, the proposed framework complements the Movement Disorder Society tremor classification and provides a practical approach to the heterogeneity of DIT. Prospective validation is needed to determine its clinical utility.

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