Valproic Acid

What is valproic acid?

Valproic acid is a prescription medicine used to treat epilepsy and bipolar disorder, and to help prevent migraine headaches. It belongs to a group of drugs called anticonvulsants or antiepileptics. You may recognise it under brand names such as Belvo, Depakote, Convulex, or Syonell. It works by calming nerve activity in the brain[1]. 

What is valproic acid used to treat?

Valproic acid is commonly prescribed to[1]: 

• Control seizures in epilepsy 

• Stabilise mood and prevent manic episodes in bipolar disorder 

• Prevent migraines (though it doesn’t treat a migraine once it’s started) 

How does valproic acid work?

This medicine increases levels of gamma-aminobutyric acid (GABA), a natural chemical in the brain that helps to calm nerve activity. By boosting GABA, valproic acid can reduce the number and severity of seizures, help stabilise mood swings in bipolar disorder, and lower the frequency of migraine attacks[1]. 

Who can take valproic acid?

Valproic acid is usually suitable for adults for migraines, bipolar disorder, or epilepsy and children aged 1 month or older for epilepsy, but it is not right for everyone. Speak to a doctor if you[1]: 

• Have liver problems or known metabolic disorders like porphyria 

• Are pregnant or could become pregnant 

• Are a man who is planning to conceive 

If you are of childbearing age, your doctor will discuss special safety measures, such as pregnancy prevention programmes, before starting treatment[1]. If you become pregnant during treatment, it is important to tell your doctor. 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].  

What is the typical dosage of valproic acid?

The dose varies depending on your age, weight, and the condition being treated. Most people start on a low dose that is gradually increased. However, the usual dose is[1]: 

• For bipolar disorder in adults: 750mg to 2,000mg a day, split into 2 or 3 doses 

• For preventing migraine in adults: 500mg to 1,000mg a day, split into 2 or 3 doses 

• For treating epilepsy in adults and children aged 12 years and over: 600mg to 2,000mg a day, split into 2 to 4 doses. Some people take a higher dose of 2,500mg a day 

• For younger children who weigh more than 20kg: the doctor will use your child’s weight to work out the right dose 

Valproic acid is usually taken once or twice daily and comes in different forms, including tablets, capsules, and liquid. Your pharmacist or doctor will advise on the most appropriate version and dose for you. 

How do you take valproic acid?

Take the medicine with or after food to reduce the risk of stomach upset. Swallow tablets or capsules whole – do not crush or chew them. Try to take it at the same time each day to keep levels stable in your body[1]. 

Can you stop taking valproic acid?

Do not stop taking valproic acid suddenly, as this may cause seizures to return or lead to mood instability. Your doctor will advise if and how you should reduce your dose gradually[1]. 

What do you do if you take too much valproic acid?

Taking too much valproic acid can be dangerous. Symptoms may include[1]: 

• Nausea or vomiting 

• Confusion or dizziness 

• Drowsiness or even loss of consciousness 

Call 999 or go to A&E immediately if you think you or someone else has taken an overdose. 

What do you do if you forget to take valproic acid?

If you forget a dose, take it as soon as you remember. If it’s nearly time for your next dose, skip the missed one and continue as normal. Do not double up to make up for a forgotten dose. Using a pillbox or reminder app can help you stay on track[1]. 

How do you store valproic acid?

Store your medicine in a cool, dry place away from direct sunlight and moisture. Keep it in the original packaging and out of reach of children. Do not use it past the expiry date printed on the packaging[1].  

What medicines can’t you take with valproic acid?

Valproic acid can interact with other medications. Speak to your pharmacist or doctor before taking[1]: 

• Other epilepsy treatments (e.g. phenytoin, carbamazepine) 

• Certain antibiotics (e.g. erythromycin) 

• Antidepressants 

• HIV or AIDS medication 

• Cholesterol-lowering medication 

• Medicines to prevent malaria 

• Medicines for stomach ulcers 

• Blood-thinning medicines like warfarin 

• Herbal or over-the-counter remedies 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of valproic acid?

Common side effects may include[1]: 

• Nausea or upset stomach 

• Tremor (shakiness) 

• Weight gain 

• Hair thinning 

• Irregular or delayed periods 

• Feeling drowsy or tired 

Serious side effects may include[1]: 

• Liver problems – look out for yellowing of the skin or eyes 

• Pancreatitis – may cause severe stomach pain, back pain, or nausea 

• Suicidal thoughts or mood changes 

• Tremors or unusual eye movements 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

 If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about dosulepin

Is valproic acid safe during pregnancy? 
No. It carries a very high risk of birth defects and developmental problems. It is important to follow your clinicians advice on pregnancy prevention and to alert your prescriber should you become pregnant. Alternatives should be explored with your doctor if you are planning pregnancy[1]. 

Can I drink alcohol while taking valproic acid? 
Avoid or limit alcohol – it can increase side effects like dizziness and drowsiness[1]. 

How long does valproic acid take to work? 
Some people notice an effect within a few days, but it may take a few weeks to reach full benefit[1]. 

Will I gain weight? 
Weight gain is a known side effect. Healthy eating and regular exercise may help[1]. 

Can I drive while taking valproic acid? 
Not until you know how it affects you. It may cause dizziness or drowsiness in some people[1]. 

Can children take valproic acid? 
Yes, but only under specialist supervision[1]. 

Can I take it with food? 
Yes – and it’s recommended to take it with or after food to avoid stomach irritation[1]. 

Is valproic acid addictive? 
No, it is not addictive[1]. 

For the official NHS guide to valproic acid, visit their website.