(val-PRO-ick acid)

NEWLY DISCOVERED USES (OFF-LABEL)
Migraine prevention in children, panic disorder, post-traumatic stress disorder (PTSD), schizoaffective disorder

ORIGINAL USES (ON-LABEL)
Used alone or in combination therapy for the treatment of complex partial seizures, simple and complex absence seizures, used in combination therapy for patients with multiple seizure types that include absence seizures and generalized seizures, for the treatment of mania associated with bipolar disorder, to prevent migraines.

BRAND NAME
Depacon, Depakene, Depakote Delayed Release, Depakote ER, Depakote Sprinkle

DRUG CLASS
Anticonvulsant, antimanic, antimigraine

DESCRIPTION
Valproic acid increases the availability of GABA, an inhibitory neurotransmitter, to the brain neurons.

POTENTIAL SIDE EFFECTS
Sleepiness, dizziness, insomnia, nervousness, hair loss, nausea, diarrhea, vomiting, abdominal pain, blood disorders, tremor, weakness, respiratory tract infection, shortness of breath, hypertension, sensation of changes in heart rhythm, peripheral edema, increased heart rate, amnesia, abnormal dreams, anxiety, confusion, bruising, dry skin, itching, loss of menstruation, painful menstruation, flatulence, increased appetite, urinary frequency, urinary incontinence, vaginitis, elevation in liver function tests, abnormal gait, joint pain, back pain, blurred vision, ringing in the ears, nosebleeds, double vision, weight gain, increased cough, pneumonia, sinusitis.

CAUTIONS
  • Not recommended for use if you have liver dysfunction, urea cycle disorders, or if you are pregnant.
  • May cause severe blood disorders, which increase the risk of bleeding.
  • Use with other anticonvulsants requires monitoring for safety and efficacy.
  • Tremors may be a sign of overdose.
  • Cases of life-threatening pancreatitis have been reported with the use of this drug.
  • Increased ammonia levels may occur and should be measured if you develop unexplained lethargy and vomiting, or changes in mental status.
  • Do not discontinue abruptly because doing so may increase seizure frequency.
  • Caution when performing tasks that require mental alertness. Sedative drugs or alcohol may increase these risks.
  • The elderly may be at higher risk of sedation and require lower doses.
  • Closely monitoring patients with psychiatric disorders for the development of suicidal ideation during initial drug therapy.
DRUG INTERACTIONS
Chlorpromazine, charcoal, cholestyramine, cimetidine, erythromycin, rifampin, aspirin and other salicylates, tricyclic antidepressants (such as amitriptyline, nortriptyline, etc.), carbamazepine, clonazepam, diazepam, ethosuximide, lamotrigine, phenobarbital, phenytoin, tolbutamide, warfarin, zidovudine

FOOD INTERACTIONS
Alcohol

HERBAL INTERACTIONS
Evening primrose

PREGNANCY AND BREAST-FEEDING CAUTIONS
FDA Pregnancy Risk Category D. Excreted in breast milk. Consult your doctor.

SPECIAL INFORMATION
This drug has a black box warning regarding the risks of liver toxicity during therapy. Increased risk for this toxic event is associated with use in small children (less than two years of age), those with congenital metabolic disorders, severe seizure disorders accompanied by mental retardation, and those with certain types of brain disease. This drug has also been reported to induce harmful effects during pregnancy (such as spina bifida). In addition, the use of this drug has caused life-threatening pancreatitis.

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