Valproate is a commonly used as well as abused anti-epileptic drug. It is a broad- spectrum anti-epileptic which means that it is effective in nearly all types of seizures viz- generalized tonic, clonic, myoclonic, absences etc. It is only marginally effective in infantile spasms and should not be used as a first line in this seizure type.
It can rarely cause irreversible liver toxicity in children below 2 years of age and should not be prescribed without due and clear counseling about rare risk of death.
It should be avoided in teenage girls due to its teratogenic potential and also other side effects like- facial hair growth, polycystic ovarian disease, weight gain, scalp hair loss.
Doses- start at 10mg /kg/ day build up to 15-20mg/kg /day in two-three divided doses.T ablets are available in 200 mg. Syrup 200mg/5ml. Children who can swallow tablets should be given extended release preparations for better compliance. Extended release tablets come in 200,300 and 500 mg to be given once or twice daily.