Mood Stabilizers as Medications valproic acid, Depakene
Mood stabilizer: valproic acid, Depakene
Generic Name: valproic acid
Brand Name(s): Depakene
Common Use: Mood stabilizer
Anticonvulsant
As sole or adjunctive therapy in the treatment of simple
or complex absence seizures, including petit mal, and is useful in primary
generalized seizures with tonic-clonic manifestations. Valproic acid may
also be used adjunctively in patients with multiple seizure types which
include either absence or tonic-clonic seizures.
Simple absence is defined as a very brief clouding of the
sensorium or loss of consciousness (lasting usually 2 to 15 seconds) accompanied
by certain generalized epileptic discharges without other detectable clinical
signs. Complex absence is the term used when other signs are also present.
Contraindications
Patients with hepatic disease or significant dysfunction.
Hypersensitivity to valproic acid.
Adverse Side Effects
The most commonly reported adverse reactions are nausea,
vomiting and indigestion. Since valproic acid has usually been used with
other antiepileptics, in most cases it is not possible to determine whether
the adverse reactions mentioned are due to valproic acid alone or to the
combination of drugs.
Gastrointestinal:
Nausea, vomiting and indigestion are the most commonly reported side effects
at the initiation of therapy. These effects are usually transient and
rarely require discontinuation of therapy. Diarrhea, abdominal cramps
and constipation have also been reported. Anorexia with some weight loss
and increased appetite with some weight gain have also been observed.
CNS Effects:
Sedative effects have been noted in patients receiving valproic acid alone,
but are found most often in patients on combination therapy. Sedation
usually disappears upon reduction of other antiepileptic medication. Ataxia,
headache, nystagmus, diplopia, asterixis, "spots before the eyes", tremor,
dysarthria, dizziness and incoordination have been noted rarely. Rare
cases of coma have been reported in patients receiving valproic acid alone
or in conjunction with phenobarbital.
Dermatologic:
Transient increases in hair loss have been observed. Skin rash and petechiae
have rarely been noted.
Endocrine:
There have been reports of irregular menses and secondary amenorrhea in
patients receiving valproic acid.Abnormal thyroid function tests have
been reported.
Psychiatric:
Emotional upset, depression, psychosis, aggression, hyperactivity and
behavioural deterioration have been reported.
Musculoskeletal:
Weakness has been reported.
Other:
Edema of the extremities has been reported.
Overdose
Naloxone has been reported to reverse the CNS depressant
effects of valproic acid overdose. Because naloxone could theoretically
also reverse the antiepileptic effects of valproic acid it should be used
with caution.
As valproic acid is absorbed very rapidly, gastric lavage may be of limited
value. Apply general supportive measures with particular attention to
the prevention of hypovolemia and the maintenance of adequate urinary
output.
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