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Sodium valproate is a derivative of a chemical called valproic acid. Medications like Depakote® combine sodium valproate and valproic acid, whereas other drugs like Depakene® use valproic acid alone. Any type of valproic acid appears effective in reducing symptoms of convulsive disorders, and likewise, there is significant off label use of Depakote® to treat bipolar disorder. It is one of the four main mood stabilizers that are used for bipolar disorders. Despite benefits of medications with sodium valproate, use is contraindicated under certain conditions or when other medications are used, and it may have minor to serious adverse effects.
Dosage of sodium valproate and its relatives can vary depending on condition, age, formulations, and response to treatment. It is used in both children and adults, and most commonly taken in an oral form (tablets, liquid). It can be intravenously infused to treat severe seizures, though this treatment is usually not considered for bipolar disorder. Rather, oral dosing goes up quickly to cause cessation of mood swings. It’s important to note that exact dose may not be the same for everyone, even if conditions and other health factors are similar.
Specific warnings exist about using sodium valproate, including that it can cause severe birth defects. Pregnant or nursing women should not use it; it also may cause some failure in oral birth control and a back-up should be used to prevent pregnancy. In children under two, there is a risk of creating liver problems or in all people, the medication can cause damage to the pancreas that does not resolve with cessation of treatment. Medications that may conflict with drugs like Depakote® include many other central nervous system depressants like antipsychotics, tranquilizers, and pain medications. The drug should be used carefully with concurrent use of topiramate, warfarin, certain antibiotics, certain antidepressants, and even medications that contain salicylates.
To monitor this medication, some physicians suggest taking regular blood levels. This can make sense, but the drug is notedly less difficult on the kidneys and liver than one of its alternatives, carbamazepine, which is also prescribed for seizures and for bipolar disorder. Patients should be warned to look for signs of extreme adverse reactions like unusual bleeding, exceptional pain in the upper abdomen and chest (pancreatitis), evidence of rash, anaphylactic response, double vision, hallucinations, or sudden onset of severe flulike symptoms.
Most people will have minor side effects with sodium valproate, and some of these are only transient, meaning they will go away as the body adjusts to the medication. Minor adverse effects are diverse. Some people experience upset stomach, constipation, nausea or changes in appetite and weight. Dry mouth isn’t uncommon and others may notice slight to severe tremors, blurred vision, and increased depression or anxiety, which should especially be noted to doctors if sodium valproate is being prescribed to treat mood disorders. Keeping in touch with prescribing doctors and mentioning concerns as they arise is advised so physicians can choose medications that are most effective with the smallest side effect burden.
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