Valproic acid: useful first-line anticonvulsant but be aware of limitations

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IN BRIEFCompared with other established anticonvulsants, valproic acid (valproate sodium) has a broad spectrum of action. It also appears to be relatively well tolerated. Valproic acid carries a lower risk of CNS and psychomotor adverse effects than other anticonvulsants. However, increases in bodyweight, gastrointestinal disturbances, tremor and transient hair loss may be troublesome. Rarely, the drug has been associated with severe hepatotoxicity and pancreatitis.The risk of neural tube defects is increased in the offspring of women receiving valproic acid. Thus, the drug should be avoided whenever possible in women wishing to conceive.

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