APPLIED PHARMACOLOGYValproic Acid in the Treatment of MigrainesBrown, Brandy L. PharmD; Craycraft, Lauren K. PharmD; Justice, Stephanie Baker PharmD, BCPSEditor(s): Weant, Kyle A. PharmD, BCPS, BCCCP, FCCP, Column Editor Author Information St. Claire HealthCare, Morehead, Kentucky. Corresponding Author: Stephanie Baker Justice, PharmD, BCPS, St. Claire HealthCare, 222 Medical Circle, Morehead, KY 40351 ([email protected]). Disclosure: The authors report no conflicts of interest. Advanced Emergency Nursing Journal: October/December 2020 - Volume 42 - Issue 4 - p 243-253 doi: 10.1097/TME.0000000000000319 Buy Take the CE Test Metrics Abstract Migraine headaches can be a disabling condition for patients. Fortunately, most patients can be successfully managed in the outpatient setting, however, there are a number of patients who may not respond to the abortive treatments that they have been prescribed. These patients often present to the emergency department (ED) for further assistance with the management of their condition. Migraines are the fourth most common cause of ED visits and are associated with an estimated annual cost of $17 billion in the United States. Familiarity with abortive treatments is critical for providers in the ED as are treatments, such as valproic acid, that may be considered in patients who do not respond to other treatment options. Many providers are more familiar with the role of valproic acid in the treatment of mood and seizure disorders, but its tolerability and the successes reported in the primary literature make it a reasonable consideration for patients with migraine who fail to respond to other therapies. This article briefly summarizes the therapies considered first line for abortive treatment in the setting of migraines and provides an overview of the primary literature describing the use of valproic acid in these patients. © 2020 Wolters Kluwer Health, Inc. All rights reserved.