Subcutaneous sodium valproate in palliative care: A systematic review

Background: Seizures are an important palliative symptom, the management of which can be complicated by patients’ capacity to swallow oral medications. In this setting, and the wish to avoid intravenous access, subcutaneous infusions may be employed. Options for antiseizure medications that can be provided subcutaneously may be limited. Subcutaneous sodium valproate may be an additional management strategy. Aim: To evaluate the published experience of subcutaneous valproate use in palliative care, namely with respect to effectiveness and tolerability. Design: A systematic review was registered (PROSPERO CRD42023453427), conducted and reported according to PRISMA reporting guidelines. Data sources: The databases PubMed, EMBASE and Scopus were searched for publications until August 11, 2023. Results: The searches returned 429 results, of which six fulfilled inclusion criteria. Case series were the most common study design, and most studies included