Name: Valproate (Depakote, Depakene)
Class: Antiepileptic Agent (Absence/Tonic-Clonic/Complex-Partial)
Mechanism: Multiple. Reduces T-channel Ca2+ currents ® seizure threshold. May enhance GABAergic neurotransmission. Inhib. sustained high freq. repetitive neuron firing.
Dist.: 80-95% protein binding.
Excretion, t½: 6-15 hr (adults), 8-15 hr (kids).
Toxicity/S.E.s: Dose-rel.—GI upset, liver enzymes, tremor, hyperammonemia, initial somnolence, behavioral changes. Non-dose-rel.—weight gain, nausea, hair loss, changes in hair texture. Idiosync.—Reye-like synd,. fetal drug effects, hepatic failure (esp. kids <2 style=""> Drug interactions (¯ w/carbamazepine, phenobarbital, phenytoin; w/felbamate).
Utility: A DOC for uncomp. gen. absence. A DOC for gen. tonic-clonic seizures. DOC for atypical absence, myoclonic & atonic epilepsy. Treat 1° & 2° gen. partial & complex-partial seizures. Treatment of bipolar disorder and mgt. of aggression or violence (off-label).
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