Valproate

Question 1

What is it indicated for?

Answer 1

Epilepsy for seizure prevention
Bipolar disorder
Migraine attacks

Question 2

How does it work?

Answer 2

It increases activity of glutamic acid decarboxylase increasing GABA production, reducing seizure discharges and propagation

Question 3

What are the side effects of these drugs?

Answer 3

Tremor
Ataxia
Behavioural disturbances
Increase liver enzymes
Thrombocytopenia
Hair loss
Abdominal upset

Question 4

What are the life-threatening side effects of the drugs?

Answer 4

Rare, life-threatening, idiosyncratic adverse effects include
severe liver injury
pancreatitis
bone marrow failure
antiepileptic hypersensitivity syndrome

Question 5

What are the warnings of these drugs?

Answer 5

Unless no other alternative avoid use in girls and women who could become pregnant

Avoid around conception and first trimester of pregnancy

Avoid in hepatic or severe renal impairment

Question 6

What interactions with other drugs can occur?

Answer 6

It inhibits liver enzymes affecting drugs metabolised by CYP enzymes

It is also affected by CYP inducers and inhibitors

Reduced efficacy with drugs that lower seizure threshold like tramadol and antipsychotics