Valproate (valproic acid, Depakote) has numerous uses which includes migraines, seizures, and bipolar disorder.



In a patient who is taking valproate, it is important to monitor for signs and symptoms of confusion as this drug can cause elevated ammonia levels.



When switching between dosage forms of valproate, you must recognize that the bioavailability is not the same between each different dosage form. This could lead to toxicity or treatment failure.



Valproic acid has a boxed warning for hepatotoxicity and liver function needs to be monitored.



Valproic acid can increase lamotrigine levels which ultimately could lead to an increased risk of lamotrigine induced SJS.