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Valproate
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==Adverse effects== {{See also|List of adverse effects of valproate|List of adverse effects of valproate semisodium}} {{Div col|colwidth=30em}} Most common adverse effects include:<ref name="Depakote FDA label">{{cite web|title=Depakote- divalproex sodium tablet, delayed release|url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=08a65cf4-7749-4ceb-6895-8f4805e2b01f |access-date=10 November 2015|url-status=live|archive-url=https://web.archive.org/web/20160305202922/http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=08a65cf4-7749-4ceb-6895-8f4805e2b01f|archive-date=5 March 2016}}</ref> * Nausea (22%) * [[Somnolence|Drowsiness]] (19%) * Dizziness (12%) * Vomiting (12%) * [[Weakness]] (10%) Serious adverse effects include:<ref name="Depakote FDA label" /> * Bleeding * [[Thrombocytopenia|Low blood platelets]] * [[Encephalopathy]] * Suicidal behavior and thoughts * [[Hypothermia|Low body temperature]] {{div col end}} Valproic acid has a [[black box warning]] for [[hepatotoxicity]], [[pancreatitis]], and fetal abnormalities.<ref name="Depakote FDA label" /> There is evidence that valproic acid may cause premature growth plate [[ossification]] in children and adolescents, resulting in decreased height.<ref>{{cite journal | vauthors = Wu S, Legido A, De Luca F | title = Effects of valproic acid on longitudinal bone growth | journal = Journal of Child Neurology | volume = 19 | issue = 1 | pages = 26β30 | date = January 2004 | pmid = 15032379 | doi = 10.1177/088307380401900105011 | s2cid = 19827846 }}</ref><ref>{{cite journal | vauthors = Robinson PB, Harvey W, Belal MS | title = Inhibition of cartilage growth by the anticonvulsant drugs diphenylhydantoin and sodium valproate | journal = British Journal of Experimental Pathology | volume = 69 | issue = 1 | pages = 17β22 | date = February 1988 | pmid = 3126792 | pmc = 2013195 }}</ref><ref>{{cite journal | vauthors = Guo CY, Ronen GM, Atkinson SA | title = Long-term valproate and lamotrigine treatment may be a marker for reduced growth and bone mass in children with epilepsy | journal = Epilepsia | volume = 42 | issue = 9 | pages = 1141β1147 | date = September 2001 | pmid = 11580761 | doi = 10.1046/j.1528-1157.2001.416800.x | s2cid = 25499280 }}</ref> Valproic acid can also cause [[mydriasis]], a dilation of the pupils.<ref>{{cite web |url=http://www.ehealthme.com/ds/depakote/mydriasis |title=Could Depakote cause Mydriasis |publisher=eHealthMe.com |date=18 November 2014 |access-date=24 April 2015 |url-status=dead |archive-url=https://web.archive.org/web/20141205082551/http://www.ehealthme.com/ds/depakote/mydriasis |archive-date=5 December 2014 }}</ref> There is evidence that shows valproic acid may increase the chance of [[polycystic ovary syndrome]] (PCOS) in women with epilepsy or bipolar disorder. Studies have shown this risk of PCOS is higher in women with epilepsy compared to those with bipolar disorder.<ref>{{cite journal | vauthors = Bilo L, Meo R | title = Polycystic ovary syndrome in women using valproate: a review | journal = Gynecological Endocrinology | volume = 24 | issue = 10 | pages = 562β570 | date = October 2008 | pmid = 19012099 | doi = 10.1080/09513590802288259 | s2cid = 36426338 }}</ref> Weight gain is also possible.<ref>{{cite journal | vauthors = Chukwu J, Delanty N, Webb D, Cavalleri GL | title = Weight change, genetics and antiepileptic drugs | journal = Expert Review of Clinical Pharmacology | volume = 7 | issue = 1 | pages = 43β51 | date = January 2014 | pmid = 24308788 | doi = 10.1586/17512433.2014.857599 | s2cid = 33444886 }}</ref> ===Pregnancy=== {{excerpt|Fetal valproate spectrum disorder}} ===Elderly=== Valproate may cause increased [[somnolence]] in the elderly. In a trial of valproate in elderly patients with [[dementia]], a significantly higher portion of valproate patients had somnolence compared to placebo. In approximately one-half of such patients, there was associated reduced nutritional intake and weight loss.<ref name="Depakote FDA label" />
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