Valproic Acid: A Reappraisal of Its Pharmacological Properties and Clinical Efficacy in Epilepsy

Valproic acid, a unique antiepileptic drug, was shown to be effective and safe for treating various seizure types in both adults and children, comparable to other antiepileptic drugs like carbamazepine and phenytoin. It primarily caused gastrointestinal side effects, with enteric-coated forms reducing discomfort, and commonly led to weight gain, tremor, and transient hair loss. It had minimal neurological side effects, making it suitable for many epilepsy patients. The risk of rare, fatal liver failure was reduced by avoiding use in high-risk patients, and there was a 1-2% risk of neural tube defects with maternal use. Valproic acid affected drug metabolism, requiring dosage adjustments for coadministered drugs. Overall, it was considered a valuable first-line treatment for a wide range of seizures.