Psychotropic
MedicationsMood Stabilizers
Valproic Acid (Depakote)
Diana Osipova
Valproic Acid (Depakote)
Generic Name
Trade Name
Indications
Valproic acid is used alone or with other medications to treat
certain types of seizures. Valproic acid is also used to treat
mania (episodes of frenzied, abnormally excited mood) in
people with bipolar disorder (manic-depressive disorder; a
disease that causes episodes of depression, episodes of
mania, and other abnormal moods). It is also used to
prevent migraine headaches but not to relieve headaches
that have already begun. Valproic acid is in a class of
medications called anticonvulsants. It works by increasing
the amount of a certain natural substance in the brain.
Mechanism of action
Works by increasing
concentrations of GABA in the
brain
Common Side
Effects
●
drowsiness
●
dizziness
●
headache
●
diarrhea
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constipation
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changes in appetite
●
weight changes
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back pain
●
Adverse Side
Effects
●
unusual bruising or bleeding
●
tiny purple or red spots on the skin
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fever
●
rash
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bruising
●
hives
agitation
●
difficulty breathing or swallowing
●
mood swings
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swollen glands
●
abnormal thinking
●
swelling of face, eyes, lips, tongue, or throat
●
uncontrollable shaking of a part of the body
●
peeling or blistering skin
●
problems with walking or coordination
confusion
●
uncontrollable movements of the eyes
●
●
blurred or double vision
●
tiredness
●
ringing in the ears
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vomiting
●
hair loss
●
drop in body temperature
●
weakness or swelling in the joints
Contraindications
Hypersensitivity, bleeding disorder, cirrhosis,
pancreatitis,
Proceed with caution when you have low
albumin and renal impairment
Benefits and Reasons
for taking Valproic Acid
Valproic acid is an anticonvulsant
and mood stabilizer medication. It
is extensively used in the adult
population to treat convulsions,
migraines, and bipolar disorders.
Nursing Implications
■
Assessment and drug effects
■
Monitor for therapeutic effectiveness achieved with serum levels of valproic acid at 50–100 mcg/mL.
■
Monitor patient alertness especially with multiple drug therapy for seizure control. Evaluate plasma levels of the
adjunctive anticonvulsants periodically as indicators for possible neurologic toxicity.
■
Monitor patient carefully during dose adjustments and promptly report presence of adverse effects. Increased
dosage is associated with frequency of adverse effects.
■
Lab tests: Perform baseline platelet counts, bleeding time, and serum ammonia, then repeat at least q2mo,
especially during the first 6 mo of therapy.
■
Multiple drugs for seizure control increase the risk of hyperammonemia, marked by lethargy, anorexia,
asterixis, increased seizure frequency, and vomiting. Report such symptoms promptly to physician. If they
persist with decreased dosage, the drug will be discontinued.
Patient and Family Education
●
Do not discontinue therapy abruptly; such action could result in loss of seizure control. Consult physician before you
stop or alter dosage regimen.
●
Note to diabetic patients: Drug may cause a false-positive test for urine ketones. Notify physician if this occurs; a
differential diagnostic blood test may be indicated.
●
Notify physician promptly if spontaneous bleeding or bruising occurs (e.g., petechiae, ecchymotic areas, otorrhagia,
epistaxis, melena).
●
Withhold dose and notify physician for following symptoms: visual disturbances, rash, jaundice, light-colored stools,
protracted vomiting, diarrhea. Fatal liver failure has occurred in patients receiving this drug.
●
Avoid alcohol and self-medication with other depressants during therapy.
●
Consult physician before using any OTC drugs during anticonvulsant therapy. Combination drugs containing aspirin,
sedatives, and medications for hay fever or other allergies are particularly UNSAFE.
●
Do not drive or engage in potentially hazardous activities until response to drug is known.
●
Inform doctor or dentist before any kind of surgery that you are taking valproic acid.
●
Carry medical identification card at all times. It needs to indicate medical diagnosis, medication(s), physician's name,
address, and telephone number.
●
Do not breastfeed while taking this drug
Resources
U.S. National Library of Medicine. (n.d.). Valproic acid: Medlineplus Drug Information. MedlinePlus.
Retrieved February 2, 2023, from https://medlineplus.gov/druginfo/meds/a682412.html
Availability. VALPROIC ACID (DIVALPROEX SODIUM, SODIUM VALPROATE). (n.d.). Retrieved February 2,
2023, from http://robholland.com/Nursing/Drug_Guide/data/monographframes/V004.html