Valproate (valproic Acid): Uses And Side Effects Of This Drug
Since ancient times, there have been hundreds of disorders and alterations that have affected human health. But among all diseases, there is one linked to the hyperexcitability of neuronal groups that is so old and virulent that it was considered “the sacred disease.”
It’s about epilepsy a condition that has been little understood until relatively recent times and that has important repercussions for those who suffer from it if they do not receive treatment.
Fortunately, the advancement of science has allowed different types of treatment to be developed, among which we can find the use of drugs. In this sense, one of the drugs that is most widely used in the treatment of this condition is valproate or valproic acid which we are going to talk about throughout this article.
Valproic acid is an anticonvulsant psychotropic drug, a type of substance that is useful to combat and prevent the appearance of seizures and seizures in general. It is one of the best-known and most used drugs in the context of the treatment of epilepsy, along with carbamazepine and topiramate.
Despite being an anticonvulsant, its chemical composition differs from the rest of the representatives of its group.
Valproate is a highly effective and potent drug (sold only by prescription), which It also has euthymizing or mood-stabilizing effects and that is considered broad spectrum. It can be found under various names, such as valproate, manganese valproate, or sodium valproate, and some of the best-known brand names are Depakote or Depakine.
Valproic acid It can be administered by two main routes, orally and intravenously The first of them is the one that is most marketed, in the form of pills or tablets, and the one that is usually applied in outpatient treatment. The intravenous version can be found in the form of vials whose contents are injected, and are usually reserved for the hospital setting or for emergency situations.
Valproic acid exerts its effects on the body thanks to a mechanism of action based on gamma-aminobutyric acid or GABA agonism, that is, in favoring the production and performance of said neurotransmitter in the body. In addition to this, it also generates a decrease in glutamate levels and alters the behavior of the sodium, potassium and calcium receptors of our neurons (reducing their conductivity).
Taking into account that glutamate is one of the excitatory neurotransmitters par excellence of our brain and that GABA is the main inhibitory neurotransmitter of the nervous system, the effects of said alterations in the levels of both will generate a reduction in nervous activity, something essential in the treatment of epilepsy (in which there is a hyperactivation of groups of neurons that have become hypersensitized, so that a minor stimulation can trigger an intense response) and in other disorders in which there is an excess of neuronal activity.
Main indications of this drug
As an antiepileptic or anticonvulsant, the main indication for valproic acid is in those people who suffer from epilepsy or seizures, both those that include seizures and the so-called “absence seizures.” This drug is prescribed in both adults and children who suffer from this condition, although it is necessary to be cautious with the doses and monitor possible side effects.
In addition, valproate is the only anticonvulsant that is officially indicated for bipolar disorder, although other drugs in the same group could also be beneficial. This is due to the aforementioned euthymizing or mood-stabilizing effect.
It is not that it increases or decreases the mood itself, but rather that it keeps it within certain limits. In this sense it is effective in the treatment and prophylaxis of manic episodes whether used together with lithium salts or administered as monotherapy.
These are not the only indications for valproic acid. In addition to the above, It is also indicated in the treatment of migraines in adult subjects, and its possible effectiveness in problems such as HIV dementia or muscle atrophy due to spinal cord damage is explored.
Side effects and risks
Valproic acid is a valuable medicine that can help treat various conditions, but its consumption can sometimes lead to undesirable and even dangerous side effects for health.
Among some of the most common side effects we can find the presence of tremors, nausea or vomiting
Other side effects may include extrapyramidal (motor) disturbances, drowsiness, involuntary eye movement, confusion, incontinence, hearing problems, transient hair loss, gum hypertrophy, oral inflammation, abdominal pain, diarrhea, weight gain or problems. memory, attention and learning, irritability and aggressiveness.
They may also appear parkinsonism (reversible), incoordination or paresthesias, dysmenorrhea and pain during menstruation, infertility (in the case of men), as well as hallucinations.
More relevant and much more dangerous (in fact with fatal potential, which is why the doses and administration of this drug have to be very controlled), although less frequent are problems such as anemia, hypothyroidism, possible thrombocytopenia or decreased blood sugar. number of platelets, decrease in blood sodium, hemorrhages and liver lesions, pancytopenia or decrease in the main components of the blood, leukopenia or decrease in white blood cells, encephalopathy, pancreatitis, osteoporosis, problems with antidiuretic hormone and decrease in electrolytes, hyperandrogenism, kidney failure, vasculitis, bone marrow failure, increased chance of myelodysplastic syndrome, infertility, rhabdomyolysis, nephritis, or clotting problems.
Despite its great usefulness in the treatment of the aforementioned conditions, valproic acid is a very powerful drug and, as we have seen, can have very dangerous side effects In this sense, there are groups and sectors of the population for whom the use of valproate is severely contraindicated.
The use of valproate is contraindicated in those people who have some type of liver, pancreas or kidney disease, especially in the case of kidney or liver failure. It is also relevant that those people with any type of hematological condition do not take it.
It is also contraindicated and not recommended for pregnant women, since it has been shown that it increases the risk of malformations in the fetus and disorders such as spina bifida, as well as the existence of a fetal syndrome due to valproate. In this sense, not only pregnant and lactating women should be careful, but also those women who are considering becoming mothers soon (it will be necessary to have an appointment with the doctor to evaluate therapeutic alternatives to valproate).
It should also not be taken by people who are allergic to valproate or any of its excipients, as well as its combined use with topiramate or MAOIs (since their interaction can be dangerous). They should not be taken with alcohol and caution should be taken with the use of hormonal contraceptives (as they may cause interaction). If other drugs are taken, the doctor should be consulted about the suitability of treatment with valproic acid.
