Valproate Adverse Events Management
Valproate is considered first-line treatment for the management of bipolar disorder with the following recommendations per recent CANMAT & ISBD 2018 guidelines:
- Acute Mania: First line as monotherapy (level of evidence: 1)
- Acute Bipolar 1 Depression: Second line as monotherapy (level of evidence: 2)
- Maintenance Treatment for the prevention of any mood episode: First line as monotherapy (level of evidence: 1)
- Bipolar 2 disorder: Third line as monotherapy (level of evidence: 4)
For this reason, it is important to have knowledge of common adverse events associated with valproate including thrombocytopenia, hair loss, and high ammonia levels. This lecture series is divided into the following three sections:
(1) VALPROATE AND THROMBOCYTOPENIA RISK:
- Most frequent clinical manifestation of thrombocytopenia.
- Who is at risk?
- likely mechanism?
- How to evaluate thrombocytopenia? (video discussion)
- Managing thrombocytopenia with valproate.
Here is one clinically relevant fact from this chapter:
(2) VALPROATE AND HAIR LOSS:
- Mechanism behind hair loss with valproate?
- Available treatment options.
(3) VALPROATE AND HIGH AMMONIA LEVELS:
- How to diagnose?
- Importance of handling the sample collection.
- Clinical feature and course.
- Risk factors.
- Evaluation and management.
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