Valproic Acid
3 medicines
Valproic acid (valproate) is an anticonvulsant and mood stabiliser used for epilepsy, bipolar disorder and migraine prevention. It causes neural-tube defects and other birth defects, so it is avoided in anyone who could become pregnant unless no other treatment works.
Key facts
- Valproic acid (valproate, sold as Depakote and Epilim) is an anticonvulsant and mood stabiliser used for epilepsy, bipolar disorder and migraine prevention.
- You take it daily as tablets, capsules or liquid, usually split into two doses; full seizure control can take several weeks to establish.
- Valproate carries the highest risk of birth defects of any anticonvulsant, including neural-tube defects such as spina bifida. It is avoided in anyone who could become pregnant unless no other treatment will control the condition, and then only under strict specialist precautions.
- Seek urgent care for yellowing of the skin or eyes, severe abdominal pain, or unusual bruising or bleeding.
What valproic acid treats
Valproic acid treats several types of epilepsy, including generalised tonic-clonic and absence seizures. It also treats bipolar disorder, stabilising mood during manic and depressive episodes, and is used to prevent migraine attacks before they start. It does not relieve a migraine that has already begun and is not a general painkiller.
How valproic acid works
Valproate raises levels of GABA, a chemical that calms nerve signalling in the brain, and it also affects sodium channels that control how easily nerve cells fire. Together these actions raise the seizure threshold and help even out swings between mania and depression.
Before you take it
- Do not take valproate if you are pregnant or could become pregnant, unless your specialist has confirmed no other treatment will work and you are following a pregnancy prevention plan with effective contraception.
- Tell your prescriber about liver disease, pancreatitis, mitochondrial disorders (especially in children), or a family history of these.
- Valproate interacts with other epilepsy medicines, certain antibiotics called carbapenems (which stop it working), and blood thinners; alcohol adds to drowsiness.
- Blood tests to check liver function and blood counts are needed before you start and periodically during treatment.
Side effects
Common effects include nausea, tremor, weight gain, temporary hair loss and drowsiness.
Stop and seek urgent medical care for any of these:
- Yellowing of the skin or eyes, severe abdominal pain, or persistent vomiting.
- Unusual bruising, bleeding, or tiny red or purple spots on the skin.
- Extreme drowsiness, confusion or repeated vomiting, which can signal a build-up of ammonia.
- Swelling of the face or lips, or difficulty breathing.
Safety essentials
- Never take valproate during pregnancy or while trying to conceive unless a specialist has confirmed there is no safer alternative: it causes neural-tube defects and other birth defects at the highest rate of any anticonvulsant. Use effective contraception if you can become pregnant.
- Liver toxicity can be fatal, especially in the first six months of treatment and in young children. Report abdominal pain, vomiting or jaundice straight away.
- Do not stop valproate abruptly. Stopping suddenly can trigger seizures, even when it is being taken for mood or migraine rather than epilepsy.
- Buy only from a licensed pharmacy and keep to the same brand where possible, since absorption can differ between formulations.
This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.