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Bipolar disorder - Management
What are the adverse effects of valproate?
- Adverse effects include:
- Gastric irritation, which can lead to intense nausea.
- Lethargy and confusion. This can occur with starting doses of more than 750 mg a day.
- Weight gain (which may be significant).
- Hair loss, with curly regrowth and peripheral oedema.
- Very rarely, fulminant hepatic failure.
- Hyperandrogenism in women. This has been linked to the development of polycystic ovaries.
- Thrombocytopenia, leucopenia, red cell hypoplasia, and pancreatitis.
- There is a small risk of suicidal thoughts and behaviour, which may be seen as early as one week after starting treatment.
- People taking valproate and healthcare professionals should be alert to any mood changes, distressing thoughts, or feelings about suicide or harming themselves at any point during treatment.
[Taylor et al, 2007; MHRA, 2008b]
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