Valproate

Question 1

NICE recommends valproate as a first-line option for the treatment of people who develop acute mania.

Valproate is available in the following three forms:

Answer 1

Semi-sodium valproate (licensed for acute mania associated with bipolar disorder)
Valproic acid (licensed for acute mania associated with bipolar disorder)
Sodium valproate (licensed for epilepsy)

Question 2

Adverse effects

Answer 2

Valproate is associated with many adverse effects the most important ones to be aware of include:-

Tiredness (This is a common side effect that can present with slowing of mental processing speed and less motivation and less spontaneity)
Significant weight gain (weight gain affects 30% to 50% of people who take valproate)
Tremor (up to a quarter of patients)
Hair loss (hair loss occurs in 5% to 10% of people who take valproate. The hair almost always grows back after the valproate is stopped, but it often has a different texture and may grow in curly instead of straight)