Valproic acid
Valproic acid
- Valproic acid is as effective as Lithium in mania prophylaxis but is not as effective in depression prophylaxis.
- Factors predicting a positive response:
- rapid cycling patients (females>males)
- comorbid substance issues
- mixed patients
- Patients with comorbid anxiety disorders
- Better tolerated than Lithium
how to use it
Valproic acid
- Before med is started: baseline liver function tests (lfts), pregnancy test and CBC
- Start folic acid supplement in women
- Monitoring: Steady state achieved after 4-5 days -check 12 hours after last dose and repeat CBC and lfts
- Goal: target level is between 50-125
side effects
Valproic acid side effects
- Thrombocytopenia and platelet dysfunction
- Nausea, vomiting, weight gain
- Transaminitis
- Sedation, tremor
- Increased risk of neural tube defect 1-2% vs 0.14-0.2% in general population secondary to reduction in folic acid
- Hair loss