Valproate, and the closely related medication divalproex, is an anticonvulsant medication used to treat several conditions, including bipolar disorder. Bipolar disorder, formerly known as manic-depressive disorder, is characterized by episodes of depression and elevated mood. It is important to see a physician for the treatment and diagnosis of bipolar disorder and other mental health conditions.
Bipolar Disorder
The prevalence of bipolar disorder is 1 to 2 percent or higher, according to "The American Psychiatric Publishing Textbook of Psychopharmacology" by Alan F. Schatzberg, professor and chairman of the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine. Bipolar disorder is associated with significant adverse outcomes and an increased incidence of death. The depression and mood elevation interfere greatly in a person's life. The cause is unknown, but development of the disease is partially hereditary. People with bipolar disorder have higher rates of other psychiatric issues such as anxiety, alcohol abuse and other substance abuse disorders. A number of therapies, including valproate, have proven helpful compared to placebo.
Valproate Mechanism
Valproate is classified as an anticonvulsant, which is a class of medications used to treat seizures. During a seizure, the electrical activity of the brain is hyperactive and evading normal control. Valproate enhances the transmission of a chemical called GABA, which slows nerve firing. For largely unknown reasons, enhancing GABA transmission with valproate helps to control bipolar disorder in some people.
Valproate Use and Efficacy
Valproate is approved for use during acute manic episodes and mixed episodes involving both mania and depression, as well as for ongoing maintenance therapy. For acute manic episodes, valproate and divalproex are likely as effective as first-line treatment for bipolar disorder, such as lithium. However, it may be inferior to lithium for maintenance therapy in some people.
Side Effects
The use of valproate leads to side effects more commonly than placebo. Some of the more common possible side effects in the central nervous system include headache, sleepiness, dizziness and tremor and, less commonly, insomnia, nervousness and pain. Hair loss is another possible side effect as is weight gain. Effects on the gastrointestinal tract may include nausea, vomiting or changes in bowel habits. Higher doses can cause blood platelets to drop in some people. Other symptoms are possible but less common. Liver damage, suicidal ideas and pancreatitis are also possible and should be monitored by a qualified health care professionals.
References
- "Basic and Clinical Pharmacology"; Bertram Katzung, et al.; 11th Ed 2009
- "Handbook of Psychiatric Drug Therapy"; Lawrence A. Labbate; 6th Ed 2010
- "The American Psychiatric Publishing Textbook of Psychopharmacology"; Alan F. Schatzberg; 4th Ed 2009
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