Valproic acid is a prescription medication classified as a carboxylic acid-derivative anticonvulsant. It is also used as a mood stabilizer for certain psychiatric conditions. This medication, available in oral forms like capsules and solutions, is sold under brand names including Depakene and Stavzor.
Conditions Treated by Valproic Acid
Valproic acid is prescribed for several medical conditions. Its principal use is managing various seizure disorders, proving effective in reducing the frequency of complex partial seizures. It is also considered a primary option for generalized seizures, such as tonic-clonic, myoclonic, or atonic types.
The medication is also a treatment for the manic episodes associated with bipolar disorder, helping to stabilize mood and control intense emotional states. Valproic acid is also used to prevent migraine headaches in adults. It is not used to treat a migraine attack that has already begun but rather to reduce the frequency of their occurrence.
Understanding How Valproic Acid Works
The therapeutic effects of valproic acid are attributed to its influence on neurotransmitters, though the precise mechanisms are not fully understood. It is believed to work by increasing the concentration of gamma-aminobutyric acid (GABA). GABA is an inhibitory neurotransmitter that blocks certain brain signals and decreases activity in the nervous system.
By enhancing GABA’s effects, valproic acid helps to calm overactive nerve signaling. This action is what allows it to control seizures, stabilize mood in bipolar disorder, and prevent the onset of migraines by reducing neural hyperexcitability.
Common Side Effects
Treatment with valproic acid can be accompanied by common side effects, which are typically not severe. Gastrointestinal issues are frequently reported, including nausea, vomiting, stomach pain, and diarrhea. Neurological effects such as drowsiness, dizziness, weakness, and tremors are also common.
Other possible side effects include changes in appetite, which can lead to weight gain, as well as hair loss. Some individuals may experience visual disturbances like blurred or double vision. While these effects are generally manageable, any new or worsening symptoms should be discussed with a healthcare provider.
Major Warnings and Required Monitoring
Valproic acid carries a U.S. Food and Drug Administration (FDA) black box warning for the risk of severe liver damage (hepatotoxicity), which can be fatal. This risk is highest during the first six months of treatment, especially in children under two and individuals with pre-existing metabolic or mitochondrial disorders. Symptoms like jaundice, facial swelling, loss of appetite, and upper stomach pain require immediate medical attention.
Another major warning involves the risk of pancreatitis, an inflammation of the pancreas that can also be fatal. Patients should be aware of the signs, including sudden and severe stomach pain that may spread to the back, nausea, and vomiting. Anyone who develops these symptoms should seek emergency medical care.
The most prominent warning is for fetal harm when taken during pregnancy. Exposure significantly increases the risk of major birth defects, particularly neural tube defects like spina bifida, and decreased IQ scores in children. Due to this risk, valproic acid should not be used to prevent migraines in pregnant individuals. For other conditions, it should only be used if other medications are not effective. Regular monitoring with blood tests to check liver function and drug levels is a standard part of treatment.