Understanding Valproic Acid and Its Purpose
Valproic acid (also known by brand names like Depakene or as divalproex sodium under Depakote) is a medication that works in the brain [1.4.2, 1.4.3]. It is classified as an anticonvulsant and mood stabilizer, approved by the FDA for treating epilepsy (seizures), the manic phase of bipolar disorder, and for preventing migraine headaches [1.4.2, 1.4.3]. Its mechanism is complex and not fully understood, but it's known to increase the levels of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain, which helps to calm nerve activity [1.5.2]. It also acts on voltage-gated sodium channels and may modulate gene expression, which contributes to its therapeutic effects [1.5.2, 1.5.5]. Due to its powerful effects, doctors often start patients on a low dose and increase it gradually to find the most effective and tolerable amount [1.2.3].
Intended Therapeutic Effects: How It's Supposed to Make You Feel
The primary goal of valproic acid is to restore balance. The intended feeling depends on the condition being treated:
- For Bipolar Disorder: The main goal is mood stabilization, particularly controlling manic episodes [1.4.2]. A person in a manic state might feel overly energetic, irritable, or have racing thoughts [1.2.4]. Valproic acid works to dampen these extremes, leading to a more even, controlled, and stable mood [1.4.5]. It can be less effective for depressive episodes compared to its anti-manic effects [1.6.1].
- For Epilepsy: The intended effect is a reduction or complete cessation of seizures [1.4.3]. By preventing the abnormal electrical impulses in the brain that cause seizures, it allows a person to feel more secure and in control of their body [1.5.2].
- For Migraine Prevention: For those who suffer from frequent migraines, the goal is to feel a significant reduction in the frequency and severity of headache days, leading to a better quality of life [1.4.3, 1.9.2].
Common Subjective Feelings & Side Effects
While the therapeutic goal is stability, the most commonly reported feelings associated with taking valproic acid are often its side effects. Many people experience these, especially when first starting the medication or after a dose increase [1.3.4].
- Drowsiness and Fatigue: One of the most frequent side effects is feeling drowsy, sleepy, or tired [1.2.1, 1.3.1]. This can be particularly pronounced in the elderly and may lead to a reduced appetite or fluid intake [1.2.2]. For this reason, many doctors advise taking the dose at bedtime.
- Dizziness and Coordination Issues: Feeling dizzy, weak, or having problems with walking and coordination are common [1.2.5]. Operating machinery or driving is not recommended until you know how the medication affects you [1.2.1].
- Gastrointestinal Issues: Nausea, vomiting, stomach pain, and diarrhea are frequently reported [1.2.5, 1.3.1]. Taking the medication with food can sometimes help mitigate these feelings [1.11.2].
- Cognitive and Mood Changes: Some individuals report 'brain fog,' abnormal thinking, or memory impairment [1.2.1, 1.3.4]. Mood swings and agitation can also occur [1.2.1].
- Changes in Appetite and Weight: Valproic acid is often associated with changes in appetite and subsequent weight gain [1.2.1, 1.8.1]. Weight gain is a primary side effect that can impact long-term use [1.8.4].
- Hair Loss: Diffused, non-scarring hair loss (alopecia) is a notable side effect associated with valproic acid and is related to the dose [1.8.2, 1.8.3].
Valproic Acid vs. Other Common Mood Stabilizers
Valproic acid is often compared to other medications used for similar conditions, such as lithium and lamotrigine. Each makes a person feel different and has a unique profile of benefits and risks.
| Feature | Valproic Acid | Lithium | Lamotrigine (Lamictal) |
|---|---|---|---|
| Primary Strength | Strong anti-manic effects; good for mixed states and rapid cycling [1.6.1, 1.6.2, 1.6.3]. | Gold standard for classic mania and long-term prevention of both manic and depressive episodes [1.6.2]. | More effective at preventing bipolar depression episodes than manic ones [1.6.1, 1.6.5]. |
| Common Feelings/Side Effects | Drowsiness, weight gain, nausea, hair loss, tremor [1.2.3, 1.8.1]. | Thirst, frequent urination, tremor, cognitive dulling, potential kidney/thyroid issues long-term. | Dizziness, headache, blurred vision, less likely to cause weight gain or sedation [1.6.3]. |
| Serious Risks | Liver damage, pancreatitis, high risk of birth defects (teratogenicity) [1.2.2, 1.7.3]. | Toxicity (narrow therapeutic window), kidney and thyroid problems. | Serious, though rare, skin rash (Stevens-Johnson syndrome) [1.6.3]. |
| Required Monitoring | Regular blood tests to check liver function and medication levels [1.3.1, 1.11.1]. | Regular blood tests to monitor drug levels (due to toxicity risk), kidney, and thyroid function. | Close monitoring for skin rashes, especially when starting the medication [1.6.3]. |
Serious Warnings and When to Call a Doctor
While many side effects are manageable, valproic acid carries black box warnings for serious, life-threatening risks. You should contact a healthcare provider immediately if you experience symptoms of:
- Liver Damage (Hepatotoxicity): Nausea, vomiting, loss of appetite, pain on the right side of your stomach, dark urine, facial swelling, or yellowing of the skin or eyes [1.2.2, 1.7.1]. The risk is highest in the first six months of treatment [1.7.4].
- Pancreatitis: Severe stomach pain (which may spread to your back), nausea, vomiting, and loss of appetite [1.7.1, 1.11.1].
- Suicidal Thoughts or Behaviors: About 1 in 500 people taking anticonvulsants like valproic acid may experience new or worsening depression, thoughts of self-harm, or unusual changes in mood or behavior [1.2.1, 1.2.2].
- Birth Defects: Valproic acid significantly increases the risk of major birth defects, such as neural tube defects (spina bifida), and can lead to lower IQ scores in children exposed in utero. It is generally not recommended for people of childbearing potential unless other options are not suitable [1.7.3, 1.7.4].
Conclusion: A Balance of Effects
So, how does valproic acid make you feel? It is a complex balance. For many, it brings a welcome feeling of stability and control over otherwise disruptive neurological and mood conditions [1.4.2, 1.4.5]. However, this benefit is often accompanied by challenging side effects like drowsiness, weight gain, and nausea [1.2.1]. The experience is highly individual, and the key to a positive outcome is constant and open communication with a healthcare provider to manage side effects and ensure the medication is working as intended. Abruptly stopping the medication can cause serious problems, including severe seizures, so any changes must be medically supervised [1.10.1, 1.11.1].
For more detailed information, you can visit the Valproic Acid page on MedlinePlus [1.2.1].
