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Anti-Convulsant Agents: Valproic Acid

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NeuroPsychopharmacotherapy

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Abstract

Valproate (VPA), one of the most prescribed antiepileptic drugs (AED), is a broad-spectrum AED which has been in use for more than 50 years. It is effective in the treatment of focal epilepsies with and without secondary generalization, as well as in all types of generalized epilepsy. Although its significance in the treatment of focal epilepsy has diminished due to the availability of new AEDs on the market, VPA still plays an important role in treating generalized epilepsy. Due to its increased risk of congenital malformations and developmental disorders in those children exposed to VPA during pregnancy, it is rarely administered to women of childbearing age nowadays. However, its mechanisms of action have not yet been fully clarified. The influence of VPA on the GABAergic inhibition, the NMDA receptor, and possibly voltage-dependent sodium channels all appear to be relevant mechanisms in the anticonvulsive action of the drug. Due to its inhibitory effect on several enzymes within the p450 system, the drug levels of various medications are affected, particularly some important AEDs. By contrast, the metabolism of VPA is influenced by different enzyme inducing drugs. These mechanisms must be carefully considered when opting to select VPA. The most common side effects include weight gain, gastrointestinal complaints, hair loss, and tremor. Additionally, VPA is available in numerous dosage forms, thus resulting in easy application.

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Authors and Affiliations

  1. Department of Epileptology, University of Bonn Medical Centre, Bonn, Germany

    Tobias R. Baumgartner

  2. Beta Neurology – Competence Center for Epilepsy, Beta Klinik GmbH, Bonn, Germany

    Christian E. Elger

Authors
  1. Tobias R. Baumgartner
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  2. Christian E. Elger
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Corresponding author

Correspondence to Tobias R. Baumgartner .

Editor information

Editors and Affiliations

  1. Dept Psychiatry , Psychosomatics & Psychotherapy, University of Würzburg, Medical School Clinical Neurochemistry, Würzburg, Germany

    Peter Riederer

  2. Inst für Psychologische Medizin, Haag, Bayern, Germany

    Gerd Laux

  3. Department of Psychiatry, University of Toronto Department of Psychiatry, Toronto, ON, Canada

    Benoit Mulsant

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

    Weidong Le

  5. Fujita Health University School Medicine, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

Section Editor information

  1. Beta Neurology – Competence Center for Epilepsy, Beta Klinik GmbH, Bonn, Germany

    Christian E. Elger

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Baumgartner, T.R., Elger, C.E. (2020). Anti-Convulsant Agents: Valproic Acid. In: Riederer, P., Laux, G., Mulsant, B., Le, W., Nagatsu, T. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_309-1

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  • DOI: https://doi.org/10.1007/978-3-319-56015-1_309-1

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  • Print ISBN: 978-3-319-56015-1

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