Valproic acid

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Also known as: Epilim, Depakote, sodium valproate, semisodium valproate

At a Glance

Why Get Tested?

To measure the amount of valproic acid in the blood and to maintain an effective level

When to Get Tested?

To detect low or excessive (potentially toxic) levels

Sample Required?

A blood sample taken from a vein in your arm

Test Preparation Needed?

None

The Test Sample

What is being tested?

This test measures the amount of valproic acid in the blood. Valproic acid is a drug that is used mainly to treat certain fitting disorders (also called seizures or epilepsy), but is also prescribed to treat bipolar disease (manic depression) and to prevent migraine headaches, though this is an unlicensed use of valproic acid in the UK. It may be used in combination with other antiepileptic drugs such as phenytoin or carbamazepine to control certain kinds of seizures.

Seizure disorders affect the brain’s ability to transmit electrical impulses and to regulate nerve activity. During a seizure, a patient may experience changes in consciousness, alterations in sight, smell, and taste, and may experience fits. Seizures can occur with rapidly developing conditions, such as high fevers, head trauma, severe infections, and exposure to toxins, and with long-term diseases such as metabolic disorders and brain tumours. In many cases, the cause is not known. The frequency of seizures varies from a single episode, to occasional, or frequent seizures. Rarely, a patient may have a seizure that does not stop without prompt medical treatment. People may experience some tiredness and a short period of confusion after a seizure. Muscles contract during a seizure and can lead to an injury and, in some cases, recurrent seizures can eventually lead to continuing brain damage, but for most people there will be little or no residual damage.  Anti-seizure medications such as valproic acid may be prescribed to reduce the frequency and severity of seizures.

Bipolar disorder is a mental disease that has cycles of depression and mania that may last for days, weeks, months, or years. During a depressive episode those affected may feel sad, hopeless, worthless, and have thoughts of suicide. During a manic episode, those affected may be euphoric, irritable, use poor judgment, and participate in risky behaviours. Valproic acid is prescribed to help even out the moods of the person with bipolar disorder, especially mania. It may also be given to some patients with recurrent migraine headaches, not to treat an acute attack but to help prevent attacks.

Valproic acid levels in the blood must be maintained within certain limits. Too little and the patient may have more symptoms (seizures, mood swings, or migraines); too much and the patient may have increased side effects. This balance is not always easily achieved. The drug is broken down by the liver, but the rate varies from patient to patient and is affected by a patient’s age and the health of their liver. In addition, valproic acid levels are often affected by other drugs such as carbamazepine, phenytoin, lamotrigine, and phenobarbital. These drugs increase the rate that valproic acid is broken down and therefore reduces its levels in the blood.

Monitoring of blood levels may be more important when someone is taking more than one drug.

The dose of valproic acid must be adjusted until a suitable concentration in the blood is reached. The amount of drug that is required to reach a steady state will vary from person to person and may change over time. Measuring the valproate level in the blood may help in this process in some cases, but is not often necessary.

How is the sample collected for testing?

A blood sample is obtained by inserting a needle into a vein in the arm.

NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.

Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed.

The Test

Common Questions

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.