Safe use of sodium valproate

Valproate is an anticonvulsant drug which is approved for use in epilepsy and bipolar disorder. It has also been used for neuropathic pain and migraine prophylaxis. Gastrointestinal adverse effects are common, particularly at the start of therapy. Important adverse effects include pancreatitis, hepatitis, weight gain and sedation. There is an increased risk of fetal abnormalities if valproate is taken in pregnancy. Measuring concentrations of serum valproate is often unnecessary. They do not correlate closely with its therapeutic effects. If withdrawal of valproate is required, this should be done slowly if possible. Rapid cessation may provoke seizures in patients with epilepsy.