The Scope and Use of Valproate in Epilepsy

Valproate emerged as a highly effective antiepileptic drug over the 15 years leading up to 1989, particularly for controlling generalized seizures as monotherapy. It was recommended to be administered in three to four doses daily due to its elimination half-life of 6 to 15 hours, which varied with other drugs and metabolic factors. While increasing dosage improved serum concentration levels, valproate also interacted with other medications, especially antiepileptic drugs. Notable side effects included tremor, weight gain, hair loss, hair growth, hepatotoxicity, and neural tube defects in offspring. Monitoring serum concentrations and seizure frequency was crucial for patient management.