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Bipolar disorder - Management
How should I prescribe valproate?
- Valproate is available in the UK in three forms:
- Semisodium valproate (Depakote®) is licensed for the treatment of acute mania (but is not licensed for use in children).
- Sodium valproate (Epilim®) and valproic acid (Convulex®) are both unlicensed for the treatment of bipolar disorder at the time of writing.
- However, a more recent review of valproate for bipolar disorder by the European Medicines Agency (EMEA) has concluded that the benefits of valproate for bipolar disorder outweigh the risks and has concluded that all product licences for medicines containing valproate should be amended to include the treatment of manic episodes in bipolar disorders when lithium is contraindicated or not tolerated [EMEA, 2009].
- Both semisodium and sodium valproate are metabolized to valproic acid, which is responsible for the pharmacological activity of all three preparations.
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