Valproate for Bipolar Disorder

Valproate sodium, sold under the American brand name Depacon, is a drug used for the treatment of manic episodes in bipolar disorder. In the broader sense, the valproate family consists of valproate sodium, valproic acid (Depakene) and divalproex sodium (Depakote). These all have the same main effect in the brain, so they are often confused with each other. Valproate is administered intravenously and is intended for short-term use only, making it most effective for treatment of acute manic episodes.

History

• Since the 1970s, lithium was the only mood stabilizer used in the treatment of bipolar disorder. But since there are a great number of side effects, drug interactions and problems with administering lithium, researchers tried testing the valproates on bipolar patients. These drugs have been used to treat bipolar disorder since the 1990s, although Depacon is not FDA-approved for this use.

Dosages

• Mood stabilizers tend to rely on blood levels of the drug to determine dosages, as opposed to the dosage itself. Blood levels of valproate should be between 40 and 150 depending upon the severity of the episode. Depacon comes in 5ml vials (equivalent to 500mg of valproic acid).

Side Effects

• The most common side effects reported when taking the valproates are gastrointestinal in nature: nausea, constipation, upset stomach and vomiting. Other side effects include weight gain, hair loss and sedation.

Warnings

• Valproate is not a drug you can stop taking all of a sudden. It should be done under a doctor's supervision, slowly tapering off the drug over a period of time. Seizures may occur if the drug is discontinued too quickly, even if you've never had a seizure before. Another risk is mixing valproate with aspirin products. The valproate drugs have an anticoagulant effect, meaning that they thin the blood and prevent it from clotting normally.

  Aspirin has the same effect, so mixing the two can pose a great danger. Because valproate heavily taxes the liver, drinking alcohol is not advised while taking the drug. In fact, liver function tests are recommended at periodic intervals to ensure that the patient's liver is properly metabolizing the medication. Lastly, the valproates are not drugs to be used during pregnancy unless the benefits to the mother outweigh the risks to the fetus.

Other Uses

• Valproates are often used to treat epilepsy, seizure disorders and migraines.