VALPROIC ACID
Trade Names: Depakene.
THERAPEUTIC INDICATIONS
Valproic acid is used in the treatment of some forms of epilepsy to reduce the incidence of crises.

Prescription is required.

USAGE
The required dosage is calculated according to body weight. We start the treatment with 15 mg / kg / day. This dose may be increased at 5 to 10 mg / kg / day every week until you have a seizure control, optimal activity of the drug may take 2 weeks to appear.

If the total daily dose exceeds 250 mg, it should be divided into several taken by mouth with meals to reduce the risk of gastric irritation.

You should not break the capsule; otherwise there may inflammation in the mouth.

When it is taken once a day, if you forget a dose, you can take as soon as you remember.

WARNINGS
You should not take valproic acid if you are allergic. Also try to avoid if you suffer from blood diseases, liver or kidney, because of the increased risk of serious complications. In the presence of mental retardation or organic brain disease, it also appears to be a greater possibility of side effects.

POSSIBLE SIDE EFFECTS
The most common complications are diarrhea , and nausea , vomiting and gastrointestinal discomfort. You can also experiment with constipation , drowsiness, incoordination of movements, tremors, dizziness , weakness, headaches, insomnia , increased salivation, increased or decreased of appetite, hair loss or enuresis.

These effects do not preclude continued treatment. By cons, you should contact your doctor if an allergic skin reaction occurs, if the skin or eyes turn yellow (liver problem), if you develop a tendency to bruise easily (a problem in the blood) or if you become agitated, aggressive, depressed or psychotic.

Valproic acid has caused sterility in male animals, when they were administered at high doses and is not known with equivalent effect in humans.

DRUG INTERACTIONS
The following medicines may increase the drowsiness effect of valproic acid: anesthetics, antidepressants, antihistamines, tranquilizers and sleeping pills.Phenobarbital has its effect and increased toxicity, the dosages should be adjusted accordingly.

If valproic acid is given with phenytoin, it should be followed closely; there may be increased seizures or, alternatively, potentiation of the action and toxicity of each drug. Its association with ISA, warfarin , dipyridamole and sulfinpyrazoneis delicate you can create clotting problems.

Carbamazepine reduces the effect of valproic acid and antacids increase it.

PRECAUTIONS
Before starting treatment with valproic acid, you must undergo the following tests: verification of the liver and kidney function, complete blood count and assessment of clotting time.

These tests will then be repeated regularly, liver function must be evaluated for two months during the first 6 months and the clotting time before surgery. This is particularly important when using also other anticonvulsant drugs.

Valproic acid may affect the results of urine tests for determining the rates of ketones.

If the drug causes drowsiness, it can impair driving and operating machinery requiring attention.

If you want to discontinue treatment with valproic acid, it must be done gradually to reduce the risk of precipitating a crisis.

During pregnancy, an attempt to reduce the minimum effective dose, especially during the last quarter.

ALTERNATIVES
You would do well if you observe carefully, for example by systematically noting the circumstances of their seizures and may well come to discover factors that cause these crises and then try to avoid them.

You can also, when they have not made crises for a long period, three years, for example, attempt, with the help of your doctor, to  reduce gradually your medication to try to do without it completely.

In biofeedback, some epileptics are able to alter their brain waves to ward off impending crises; this is a very promising way.

OVERALL ASSESSMENT
Valproic acid is an anticonvulsant effective it had been hoped in its introduction that it does not have serious side effects of other AEDs. Indeed, toxic effects are less frequent, but they are often serious cons.

It can cause serious liver damage that have even proved fatal in four people who used it in combination with other anticonvulsants. We generally prefer to use older drugs or, if used (in cases where conventional drugs are not effective), we have regular tests required to detect any abnormalities.