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Mood Stabilizers: Valproate

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NeuroPsychopharmacotherapy

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Abstract

Valproate is a simple branched-chain carboxylic acid. It was first used as an organic solvent, before it was discovered as an effective anti-convulsant in the 1960s. Although valproate has approval by most agencies for treatment of acute mania in bipolar disorder only, it is widely used off-label as maintenance treatment as well as for a number of other psychiatric disorders and symptoms in clinical practice. Available studies, including a limited number of randomized clinical trials, support the use of valproate for treatment in acute mania, although it has not been proven to be superior to other treatment options such as lithium or atypical antipsychotics. There is also limited evidence for its (off-label) use as long-term treatment to prevent relapses in bipolar disorders; however, valproate is also not superior to lithium in this indication either. During valproate treatment, a number of side effects may occur with rare but potentially life-threatening toxic effects. In particular, its teratogenic effects make it non-suitable for female patients in child-bearing age. When used in combination with other medications, inhibition of cytochrome enzymes and UDP-glucuronosyltransferases needs to be considered.

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Author information

Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany

    Maximilian Schäfer & Eva Janina Brandl

  2. Psychiatrische Universitätsklinik der Charité im St. Hedwig-Krankenhaus, Berlin, Germany

    Eva Janina Brandl

Authors
  1. Maximilian Schäfer
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  2. Eva Janina Brandl
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Corresponding author

Correspondence to Eva Janina Brandl .

Editor information

Editors and Affiliations

  1. Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany

    Peter Riederer

  2. Institute of Psychological Medicine (IPM), Soyen, Germany

    Gerd Laux

  3. Centre for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Würzburg, Germany

    Christian Riederer

Section Editor information

  1. Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Würzburg, Germany

    Andreas Menke

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Schäfer, M., Brandl, E.J. (2022). Mood Stabilizers: Valproate. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_49

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  • DOI: https://doi.org/10.1007/978-3-030-62059-2_49

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-62058-5

  • Online ISBN: 978-3-030-62059-2

  • eBook Packages: MedicineReference Module Medicine

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