Valproic acid (VPA) is basically an anticonvulsant medicine derived from natural valeric acid. The drug is mainly used for the treatment of certain forms of seizures, including epilepsy (Ghodke-Puranik et al., 2014; Li et al., 2019). It is also used in the management of manic-depressive illness associated with bipolar disorder (Blokdijk, 2018). The medication is as well helpful in the prevention of migraine, anxiety, mood, and various types of psychiatric disorders (Ghodke-Puranik et al., 2014; Blokdijk, 2018). VPA is available in form of syrups, tablets, and capsules. This drug can be used either alone or it can be combined with other medicines used in the management of both complex and simple seizures.
In prescribing VPA to patients of different ages, there are important steps that a healthcare provider is supposed to follow. Prior to the prescription, it is important to enlighten the patient on how the drug works up. This can be achieved through provision of patient education on the mode of action of the medicine. VPA mainly woks by regulating the balances of some transmitters present in the brain (Boucher, 2017). For instance, when used to treat epilepsy, this medicine acts by way of increasing the amount of gamma-aminobutyric acid (GABA) (Boucher, 2017; NIH, 2021). This leads to the stabilization of the various symptoms associated with the condition.
Before the patient starts taking VPA, it is necessary for the healthcare provider to determine whether he or she has signs and symptoms of depression, suicidal thoughts, liver problems, urea cycle disorder, and human immunodeficiency virus (HIV) (Li et al., 2020; Multum, 2020). The usage of the drug by patients with such conditions can only worsen their health situations. It is also important to note that the drug is not suitable for women who are either pregnant or breastfeeding (Boucher, 2017). It can lead to birth defects and harmful health outcomes among newborns. The initial dosage of VPA is 10 to 15 milligrams (mg) or kilograms (kg) per day (Rahman & Nguyen, 2021). However, this sometimes depends on the age of the patient and the severity of his or her condition. Once the patient starts taking VPA, he or she should not stop (Boucher, 2017). His or her condition can worsen if the medication is stopped. However, there is need to decrease the dosage gradually.
Some of the most common side effects of VPA include black stool, bleeding gums, urine containing blood, coughing, diarrhea, vomiting, loss of appetite, mental depression, difficulties in breathing, fever, sweating, headache, sore throat, troubles in sleeping, unusual weakness, weigh loss or gain, mood swings, poor judgment, speech and memory problems, and preoccupation with false beliefs and unreal feelings (Totan et al., 2017; Multum, 2020). Less common side effects include fear, anxiety, abnormal dreams, blurred vision, changes in personality, chest pains, muscle stiffness, difficulties in movement, dizziness, indigestion, and restlessness (Totan et al., 2017). When taking VPA, it is important to monitor complete blood cell (CBC) count, liver function, pregnancy progression, and manifestation of the polycystic ovary disease (Li et al., 2020). Tests on the same should be conducted after every three or six months (Li et al., 2020). This can help to ensure that the side effects associated with VPA are effectively managed. If the side effects persist, it is necessary to consider reducing the dosage of the drug (Blokdijk, 2018). In case this measure does not work, the patient should consult a healthcare provider.
References:
Blokdijk, G. J. (2018). Valproic Acid: Third Edition. CreateSpace Independent Publishing Platform.
Boucher, A. (2017). Valproic acid: Pharmacology, mechanisms of action and clinical implications. New York: Nova Biomedical.
Ghodke-Puranik, Y., Thorn, C. F., Lamba, J. K., Leeder, J. S., Song, W., Birnbaum, A. K., Altman, R. B., & Klein, T. E. (2014). Valproic acid pathway: pharmacokinetics and pharmacodynamics. Pharmacogenet Genomics, 23 (4): 236-241. doi: 10.1097/FPC.0b013e32835ea0b2
Li, Y., Jiang, Y., & Cao, H. (2020).Therapeutic drug monitoring of valproic acid using a dried plasma spot sampling device. Journal of Mass Spectrometry, 56 (4): e4603. https://doi.org/10.1002/jms.4603
Li., R., Qin, X., Liang, X., Liu, M., & Zhang, X. (2019). Lipidomic characteristics and clinical findings of epileptic patients treated with valproic acid. Journal of Cellular and Molecular Medicine, 23 (9): 6017-6023. https://doi.org/10.1111/jcmm.14464
Multum, C. (2020). Valproic Acid. Retrieved from https://www.drugs.com/mtm/valproic-acid.html
National Institute of Health (NIH). (2021). Valproic Acid. Retrieved from https://www.cancer.gov/publications/dictionaries/cancer-drug/def/valproic-acid
Rahman, M., & Nguyen, H. (2021). Valproic Acid. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK559112/
Totan, Y., Guler, E., Yuce, A., & Dervisogullari, M. S. (2017). The adverse eff
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