by Dr. Manura Nanayakkara

Created on: July 01, 2010

Sodium valproate is a drug prescribed for epilepsy, bipolar affective disorder and migraine. This drug is found to have some anti-psychotic properties and it is used in some centers to treat schizophrenia as well. Main problems with this drug are increased risk of suicide and liver toxicity. Popular brands are Epilim ®, Convulex®, Depakote® and Episenta®.

 The doctor needs patient’s complete medical history including over the counter medications he/she is taking. If the patient is having liver problems, it is very important to inform that to the doctor, before prescribing Sodium valproate. If the patient is pregnant or planning to get pregnant, then the doctor should know that as well.

 Monitoring patient’s liver and pancreatic function during the treatment is also very important. Patient should know the features of liver and pancreatic dysfunction as well. These symptoms include markedly reduced appetite, yellowish discoloration of the body, severe abdominal pain and nausea/vomiting. During the therapy, the doctor frequently carries out blood tests to see whether the patient’s liver is coping well.

 This medication is available as tablets and injections. Tablets should be taken as a whole without crushing and should be taken with a full glass of water to minimize side effects. Injections are used in infants and for the patients who are having status epilepticus.

 Use in epilepsy

This medication is prescribed for all types of epilepsies. It is especially effective in typical and atypical absence seizures. This medication can be prescribed alone or in combination with other anti – epileptics. Sodium valproate is usually prescribed for longer duration to prevent the recurrence of seizures. Valproate Injections are used in Status epilepticus. This is characterized by a fit (seizure) lasting more than 30 minutes.  

 Use in Bipolar disorder

Sodium Valproate is used to treat manic episodes in the bipolar affective disorder. This is used alone or in combination with other anti manic drugs such as Lithium. This medication is especially useful in patients who do not tolerate lithium. Patients with a rapid cycling mood (changes to the mood from elation to depression over a short period of time) are benefited by this drug as well. Effect of this drug is usually observed after two to three weeks.

 Use in Migraine

Sodium valproate is found to be effective in preventing migraine attacks by several evidence based studies. Injections are used to treat acute migraine attacks as well.

 Use in schizophrenia

This medication is sometimes prescribed in combination with other anti-psychotics for the treatment of schizophrenia.

 Main side effects

Commonest side effects are nausea, vomiting, gastric irritation, weight gain, increased ammonia in blood and transient hair loss with curly regrowth. This medication is known to cause fetal harm in pregnancy.

 Sources

British National Formulary

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