This medicine must not be taken by women of childbearing potential without effective contraception and a clear conversation with their doctor about the risks. This requirement is reviewed at every appointment.
What it treats
Which conditions is Sodium Valproate used for?
Overview
What is Sodium Valproate?
Sodium valproate (also called valproic acid) is both a mood stabiliser and an anticonvulsant. It is one of the most commonly prescribed medicines in psychiatry and neurology in Kenya and globally.
For bipolar disorder, it is particularly effective for managing the manic phase and is often used for long-term mood stabilisation. For epilepsy, it controls a broad range of seizure types. It is listed in Kenya's Essential Medicines List 2023 under both mental health and epilepsy categories.
Valproate is among the most effective treatments available for its indications. However, it carries the highest risk of harm to an unborn baby of any psychiatric medicine. This is not a reason to avoid it in all circumstances, but it is an absolute reason for any woman of childbearing age taking it to use effective contraception and have an ongoing conversation with their doctor about family planning.
How it works
What does it do in the brain?
Formulations in Kenya
How is it available?
Availability across Africa
Where is it available in Africa and what is it called?
| Country | Common Brand Name(s) | Notes |
|---|---|---|
| Uganda | Epilim, Valproate (generic) | On the Uganda EML; available from district hospital level for epilepsy and at psychiatric hospitals for bipolar. |
| Tanzania | Epilim, Valproate (generic) | On the Tanzania EML; widely used for epilepsy and available at most referral hospitals. |
| Ethiopia | Valproate (generic) | On the Ethiopian EML; widely available for epilepsy management at district and referral level. |
| Rwanda | Epilim, Valproate (generic) | Available through the RBC pharmacy network at district hospitals and above. |
| South Africa | Epilim, Depakine, Valproate (generic) | Widely available; generic dispensed across public sector. Pregnancy Prevention Programme requirements actively applied. |
| Nigeria | Epilim, Valparin | Available at all teaching hospitals and most government facilities. |
| Ghana | Epilim, Valproate (generic) | On the Ghana EML; available at all teaching hospitals and district hospitals for epilepsy. |
| Zambia | Epilim, Valproate (generic) | On the Zambia EML; available at government hospitals for epilepsy management. |
Side effects
What might you feel while taking it?
These are the most commonly reported effects. Not everyone experiences them, and many settle within the first few weeks.
- Nausea, stomach discomfort, or vomiting, taking it with food significantly reduces this
- Weight gain
- Hair thinning, often temporary
- Tremor of the hands
- Sedation and cognitive slowing at higher levels
- Changes in menstrual cycle in women
- Raised liver enzymes, usually temporary, but monitored
- Harm to an unborn baby. The most serious risk, and the reason for strict pregnancy precautions
- Liver failure, rare but possible, particularly in young children and people with certain metabolic conditions
- Pancreatitis, report severe abdominal pain promptly
- A rise in ammonia in the blood causing confusion or unusual drowsiness, contact your doctor if this occurs
Who should not take it
Important warnings before starting
- Pregnancy, or any situation where pregnancy is possible without effective contraception and informed discussion with a doctor
- Personal or family history of certain rare metabolic disorders
- Significant liver disease
Special care needed
Situations that need extra attention
- Women of childbearing age must use effective contraception, confirmed at every appointment
- If you are considering pregnancy, speak to your specialist well in advance
- Report any severe abdominal pain immediately
- Report any unusual confusion or excessive drowsiness
- Do not stop the medicine suddenly without medical guidance
Valproate carries the highest risk of birth defects and developmental harm of any mood stabiliser. If you might become pregnant, discuss this actively with your doctor. If pregnancy is confirmed, do not stop without immediate specialist input.
Low levels pass into breast milk and this is generally considered acceptable. Your doctor will assess your individual circumstances.
Other medicines
Medicines and substances that can interact with it
- Lamotrigine: Valproate significantly increases lamotrigine levels in the blood. If both medicines are prescribed together, your doctor will use a different dosing approach for lamotrigine.
- Carbamazepine: A complex interaction that affects both medicines. If used together, both levels need monitoring.
- Aspirin and anti-inflammatory medicines: Can raise valproate levels. Inform your doctor if you take these regularly.
- Blood thinners such as warfarin: Valproate can affect how the body handles warfarin. Monitoring of clotting levels is needed.
Tests and follow-up
What your doctor will monitor
- Liver function tests before starting and regularly in the first six months, then annually
- Blood valproate levels checked when there is uncertainty about dose adequacy
- Full blood count periodically, valproate can affect blood clotting
- Weight at every appointment
- For women of reproductive age: confirmation of effective contraception at every appointment
Stopping this medicine
What happens if you stop taking it?
In Kenya
What you should know about this medicine in Kenya
Sodium valproate is one of the most affordable and widely available mood stabilisers and anticonvulsants in Kenya. Its accessibility at Level 3 makes it reachable for people far from specialist facilities.
The pregnancy risk is a significant public health concern in Kenya, where family planning conversations in clinical settings are not always consistent. Healthcare providers prescribing valproate to women of reproductive age have a responsibility to have this conversation clearly and document it.
Its dual role in epilepsy and bipolar disorder reflects the real clinical overlap between neurological and psychiatric conditions.
Sources
References
- Ministry of Health, Kenya. (2023). Kenya Essential Medicines List 2023. Nairobi: Ministry of Health.
- Ministry of Health, Kenya. (2023). Kenya National Medicines Formulary, 1st Edition. Nairobi: Ministry of Health.
- Tomson, T., et al. (2018). Comparative risk of major congenital malformations with eight different antiepileptic drugs. The Lancet Neurology, 17(6), 530-538.
- World Health Organization. (2023). Model List of Essential Medicines, 23rd Edition. Geneva: WHO.