Valproic Acid
Key points
- Valproic acid (di-n-propylacetic acid) is an anticonvulsant drug chemically unrelated to other psychiatric medications.
- It is produced in various preparations, including syrup, sprinkles, capsules, enteric-coated capsules, and tablets.
- One of the more commonly used preparations is divalproex sodium (Depakote), a compound of sodium valproate and valproic acid in a 1:1 molar ratio.
- Absorption is different across the different preparations and is delayed by food.
Antidepressant and Antimanic Medications: Valproic Acid
Valproic acid (di-n-propylacetic acid) is an anticonvulsant drug chemically unrelated to other psychiatric medications. It is produced in various preparations, including syrup, sprinkles, capsules, enteric-coated capsules, and tablets. One of the more commonly used preparations is divalproex sodium (Depakote), a compound of sodium valproate and valproic acid in a 1:1 molar ratio. Absorption is different across the different preparations and is delayed by food. However, because anticonvulsant efficacy is not related to peak levels but rather to total daily bioavailable dose, this variability is thought to be clinically irrelevant. Peak plasma levels are achieved between 2 and 4 hours after ingestion, and the half-life ranges from 6 to 16 hours. More than 90% of plasma valproic acid is protein-bound. The time of dosing is determined by possible side effects, and, if tolerated, a once-a-day dosing could be employed. The therapeutic plasma levels used for the treatment of mania are the same as those used for anticonvulsant therapy (50-100 μg/mL), and the total daily dosage required to achieve these levels ranges from 500 mg to 1,500 mg.
Valproic acid is metabolized by the hepatic CYP2D6 system but, unlike carbamazepine, does not autoinduce its own metabolism. Concomitant administration of carbamazepine will decrease plasma levels of valproic acid, and drugs that inhibit the CYP system (e.g., SSRIs) can cause an increase in valproic acid levels.
Antidepressant and Antimanic Medications Introduction Diagnostic Indications and Contraindications
Written and revised by
Gerald Hurowitz, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.
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