Valproic acid is a useful medication that is indicated for several health conditions but may lead to significant side effects in some individuals. There are a large number of possible adverse effects that have an impact on many different organs and systems in the body.
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Severe Effects
In some cases, individuals may be allergic to valproic acid, leading to a potentially dangerous situation when an allergic reaction occurs. If patients notice signs of hypersensitivity, they should seek medical advice as soon as possible to prevent unfavorable outcomes.
Valproic acid has the potential to cause life-threatening damage to the liver, particularly for young children taking multiple medications in the first six months of therapy.
It can also cause serious damage to the pancreas that has fatal potential. Pain in the stomach area and back, accompanied by nausea, vomiting, or loss of appetite may be indicative of pancreatitis and warrants further investigation and possible treatment.
Pregnant women and women who are planning to become pregnant in the near future should be advised against taking valproic acid, as there is a high risk of birth defects. It is recommended that all women of childbearing age take appropriate contraceptive precautions to avoid conceiving whilst being treated with valproic acid.
Gastrointestinal Effects
Gastrointestinal complications are the most common side effects associated with the use of valproic acid. These effects may include:
- Abdominal pain
- Diarrhea
- Dyspepsia
- Gingival disorder
- Nausea
- Vomiting
- Constipation
- Dry mouth
- Fecal incontinence
- Flatulence
- Gastralgia
- Gastroenteritis
- Pancreatitis
Most of these effects are transient and subside with continued use or upon removal of the medication.
Hepatic Effects
It is common for liver enzymes such as bilirubin to increase as a result of therapy with valproic acid, particularly in the initial stages of treatment. This can lead to injury and damage to the liver and possible hepatic failure.
If signs of hepatic dysfunction become evident, such as elevation of transaminases and amylase in the blood, it is recommended to reduce the dose to manage this.
Nervous System
Side effects related to the nervous system that commonly occur to people taking valproic acid treatments include:
- Dizziness
- Headache
- Tremor
- Abnormal gait
- Convulsion
- Incoordination
- Enhanced reflexes
- Memory impairment
- Dyskinesia
Cardiovascular
Common cardiovascular adverse effects include:
- Edema
- Hypertension
- Hypotension
- Tachycardia
- Peripheral edema
Dermatological
Common dermatological adverse effects that occur include:
- Alopecia
- Dry skin
- Rash
- Itch
- Seborrhea
Changes in hair growth and increased sweating may also occur but are less commonly reported.
Genitourinary
Common adverse effects to the genitourinary system include:
- Amenorrhea
- Cystitis
- Dysmenorrhea
- Dysuria
- Urinary incontinence
- Increased frequency of urination
- Vaginitis
Psychiatric Effects
Common psychiatric side effects include:
- Nervousness
- Abnormal dreams
- Aggression
- Agitation
- Confusion
- Depression
- Hallucinations
- Insomnia
- Attention disorders
- Behavior abnormalities
- Hyperactivity
- Learning disorders
Children taking valproate treatment are particularly prone to learning and attention disorders, hyperactivity, and abnormalities in behavior.
Other Effects
There are several other effects to other areas of the body, such as:
- Hematological: thrombocytopenia, anemia, hemorrhage
- Musculoskeletal: arthralgia, arthrosis, cramping, myalgia, twitching
- Ocular: blurred vision, diplopia, abnormal vision, conjunctivitis, dry eyes, eye pain
- Respiratory: Respiratory infection, dyspnea, cough
- Gastrointestinal: increased appetite, weight loss or gain, anorexia
Other side effects such as back pain, chills, edema, fever, malaise and other infections may also occur.
This is not a complete list of all the possible side effects of valproic acid and a patient may report other signs as a result of taking the medication. These should be managed appropriately to ensure the optimal health of the individual and reported to regulating bodies to alert future patients that may need to use valproic acid.
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