What Is Valproic Acid Used For?

Valproic acid is a drug that requires a prescription, mainly indicated for the treatment of different types of epilepsy. However, it's also used to treat bipolar disorder in certain situations.
What Is Valproic Acid Used For?

Last update: 21 January, 2021

Valproic acid is a drug used primarily to treat epilepsy. Doctors normally use it to treat generalized or partial epilepsy.

In addition, they use it to treat manic episodes in bipolar disorder when lithium isn’t an option, not tolerated, or if the patient doesn’t respond adequately, such as in patients with mixed manic episodes.

Let’s take a closer look at these two diseases for which you can use valproic acid.

What is epilepsy?

Epilepsy is a chronic disease with recurrent critical episodes: epileptic seizures. These seizures are excessive discharges with a sudden onset and end, which are triggered in an uncontrolled manner by a large number of neurons.

These discharges are the clinical expression of a functional change in the brain due to a cortical neuron disorder that causes, at the same time, several abnormal discharges at a certain point in the central nervous system (CNS) called the epileptogenic focus.

Likewise, experts believe that epilepsy is caused by neuronal depolarization/repolarization, that is, electrical changes in the membrane of these cells. However, there are several hypotheses about the causes of epilepsy. Here are some of them:

  • It’s due to high levels of the neurotransmitter glutamate and low GABA levels (the depressant neurotransmitter of the CNS)
  • Cholinergic and monoaminergic influences
  • Changes in the intra and extracellular relationship of ions
  • Fetal abnormalities in neuronal migration
Clipboard with medications and "epilepsy" written on it.
Valproic acid is a drug doctors use as part of a the treatment for epilepsy. Epilepsy comes in sudden starts and stops.

What about bipolar disorder?

As we’ve mentioned, the main use of valproic acid is to treat epilepsy. However, doctors often use this drug for patients with bipolar disorder in whom first-line treatment for bipolar disorder doesn’t work.

One adult in every 100 suffers from this disorder. It usually begins during or after adolescence. Additionally, it affects women and men equally.

Bipolar disorder, as its name suggests, is characterized by sudden mood changes. These changes usually last for several weeks or months and are beyond what healthy people experience. These changes are:

  • Lows or depressions: feelings of intense depression and hopelessness.
  • Highs or manias: feelings of extreme happiness and hopelessness.
  • Mixed: for example, feeling depressed and at the same time feeling the restlessness and over-activity of a manic phase.

However, to this day, doctors don’t know the triggers of this disease. They believe it could be related to genetic factors, more than situational or learned behavior.

Also, there could be a physical disorder in the brain system that controls mood. This explains why patients can often control bipolar disorder with medication. Stressful situations or physical illnesses can also precipitate mood changes.

How does valproic acid work?

Different pharmaceuticals, some containing valproic acid.
Valproic acid works by increasing GABA synthesis and inhibiting sodium and calcium channels. In addition, it has other mechanisms of action.

This drug is structurally related to GABA and has multiple mechanisms of action, such as:

  • Increasing GABA synthesis
  • Inhibiting degradation by blocking GABA-T
  • Increasing the release of this neurotransmitter and decreasing aspartate levels
  • Inhibiting sodium and calcium channels

GABA, like other substances such as serotonin or adrenaline, is a chemical the body synthesizes and is responsible for transmitting signals from one neuron to the next one.

Depending on the neurotransmitter, it will transmit one type of signal or another, triggering a different signaling chain. In the case of GABA, it’s secreted –  it emits signals to inhibit or reduce neuronal activity.

Side effects of valproic acid

This drug, like others, also has a series of side effects that doctors must take into account when administering it. Due to this, doctors limit the use of this drug, since it causes liver toxicity and has side effects, including:

  • Epigastric pain
  • Nausea and vomiting
  • Isolated reversible parkinsonism

Likewise, doctors normally administer it, along with other antiepileptic drugs, in myoclonic epileptic patients, in childhood absence epilepsy, in infantile spasms, and in Lennox-Gastaut syndrome (a rare disease).

Conclusion

Valproic acid is a drug that requires a prescription, mainly for the treatment of different types of epilepsy. However, doctors also use it to treat bipolar disorder in certain situations. You should exercise caution while taking it as it’s not exempt from causing side effects.

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