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Valproic acid, Depakote for bipolar mania and mixed states

Valproic acid
Brand names: Depakote®, Depakene®, Depakote® ER, Depakote® Sprinkle

Valproic acid is in a class of medications called anticonvulsants. It is used to treat mania or mixed episodes in people with bipolar disorder.  It is also used to treat certain types of seizures and to prevent migraine headaches.

How is it taken?
Valproic acid comes as a capsule, an extended-release (long-acting) tablet, a delayed-release (slow to begin working) tablet, a sprinkle capsule (capsule that contains small beads of medication that can be sprinkled on food), and a syrup (liquid) to take by mouth. The syrup, capsules, delayed-release tablets, and sprinkle capsules are usually taken two or more times daily. The extended-release tablets are usually taken once a day.

Take valproic acid at around the same time(s) every day. Take valproic acid with food to help to prevent stomach upset. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Your doctor may start you on a low dose of valproic acid and gradually increase your dose.

If you forget a dose, take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Store it at room temperature, away from excess heat and moisture (not in the bathroom).

What do I need to tell my doctor?
Tell your doctor if:

  • you are pregnant or plan to become pregnant. If you become pregnant while taking valproic acid, call your doctor immediately. Valproic acid can cause birth defects.
  • you are taking, or plan to take, any prescription or over-the-counter drugs, including herbal remedies and nutritional supplements. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • you are allergic to any medications
  • you are breast-feeding
  • you are having surgery, including dental surgery. The doctor or dentist needs to know that you are taking valproic acid.
  • you or anyone in your family have or have ever had a urea cycle disorder

What are its side effects?
Tell your doctor if any of these symptoms are severe or do not go away:

  • drowsiness
  • dizziness
  • headache
  • diarrhea
  • constipation
  • heartburn
  • changes in appetite
  • weight changes
  • back pain
  • agitation
  • mood swings
  • abnormal thinking
  • memory loss
  • uncontrollable shaking of a part of the body
  • loss of coordination
  • uncontrollable movements of the eyes
  • blurred or double vision
  • ringing in the ears
  • stuffed or runny nose
  • sore throat
  • hair loss

Serious side effects
If you experience any of the following symptoms, call your doctor immediately:

  • unusual bruising or bleeding
  • tiny purple spots on the skin
  • fever
  • blisters or rash
  • itching
  • hives
  • confusion
  • difficulty breathing or swallowing
  • swollen glands
  • weakness in the joints
  • depression
  • thinking about killing yourself or planning or
  • trying to do so

Some people have experienced serious liver problems while taking valproic acid. Your doctor should check your liver function before you start this medication and at frequent intervals thereafter.

Valproic acid may cause serious or life-threatening damage to the pancreas. This may occur at any time during your treatment. If you experience any of the following symptoms, call your doctor immediately: stomach pain, nausea, vomiting, or loss of appetite.

Do not stop taking valproic acid without talking to your doctor. If you suddenly stop taking valproic acid, you may experience a severe, long-lasting and possibly life-threatening seizure.

What else do I need to know?
Do not stop taking valproic acid without talking to your doctor. If you suddenly stop taking valproic acid, you may experience a severe, long-lasting and possibly life-threatening seizure.

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:

  • sleepiness
  • irregular heartbeat
  • coma (loss of consciousness for a period of time)

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