Valnoctamide

Valnoctamide (INN, USAN) has been used in France as an sedative-hypnotic since 1964.^[2] It is a structural isomer of valpromide, a valproic acid prodrug; unlike valpromide, however, valnoctamide is not transformed into its homologous acid, valnoctic acid, in vivo.^[3]

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Indications

In addition to being a sedative, valnoctamide has been investigated for use in epilepsy since 1969^[4] and was still being investigated in 2000^[5] and 2003.

It was studied for neuropathic pain in 2005 by Winkler et al, with good results: it had minimal effects on motor coordination and alertness at effective doses, and appeared to be equally effective as gabapentin.^[6]

RH Belmaker, Yuly Bersudsky and Alex Mishory started a clinical trial of valnoctamide for prophylaxis of mania in lieu of the much more teratogenic valproic acid or its salts.^[7]

Side effects

The side effects of valnoctamide are mostly minor and include somnolence^[8] and the slight motor impairments mentioned above.

Interactions

Valnoctamide is known to increase through inhibition of epoxide hydrolase the serum levels of carbamazepine-10,11-epoxide, the active metabolite of carbamazepine, sometimes to toxic levels.^[9]

Chemistry

Valnoctamide is a racemic compound with four stereoisomers, all of which were shown to be more effective than valproic acid in animal models of epilepsy and one of which ((2S,3S)-valnoctamide) was considered to be a good candidate by Isoherranen, et al for an anticonvulsant in August of 2003.^[10]

Notes and references