Valproic acid is used alone or with other medications to treat certain types of seizures. Valproic acid is also used to treat mania (episodes of frenzied, abnormally excited mood) in people with bipolar disorder (manic-depressive disorder; a disease that causes episodes of depression, episodes of mania, and other abnormal moods). It is also used to prevent migraine headaches but not to relieve headaches that have already begun. Valproic acid is in a class of medications called anticonvulsants. It works by increasing the amount of a certain natural substance in the brain.

Valproic acid comes as a capsule, an extended-release (long-acting) tablet, a delayed-release (releases the medication in the intestine to prevent damage to the stomach) tablet, a sprinkle capsule (capsule that contains small beads of medication that can be sprinkled on food), and a syrup (liquid) to take by mouth. The syrup, capsules, delayed-release tablets, and sprinkle capsules are usually taken two or more times daily. The extended-release tablets are usually taken once a day. Take valproic acid at around the same time(s) every day. Take valproic acid with food to help prevent the medication from upsetting your stomach. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take valproic acid exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Valproic acid can cause liver failure that may be fatal, especially in children under age 2 and in people with liver problems caused by certain genetic disorders. You should not use valproic acid if you have liver disease, a urea cycle disorder, or a genetic disorder such as Alpers' disease or Alpers-Huttenlocher syndrome. Valproic acid may harm an unborn baby, but having a seizure during pregnancy could harm both mother and baby. The benefit of preventing seizures may outweigh any risks to the baby. Do not use valproic acid to prevent migraine headaches if you are pregnant.

The most common side effects with Depakote include nausea, vomiting, extreme drowsiness, dizziness, weakness, abdominal pain, stomach upset, rash, diarrhea, increased appetite, pain, tremor, weight gain, back pain, hair loss, headache, fever, loss of appetite, constipation, double/blurred vision, side-to-side eye movements, staggering, emotional upset, abnormal thinking, amnesia, flu syndrome, infection, bronchitis, runny nose, bruising, swelling of the arms or legs, insomnia, nervousness, depression, sore throat, shortness of breath, and ringing of the ears. Other side effects reported with Depakote include hypertension (high blood pressure) and hypotension (low blood pressure).

What happens if you crush Depakote ER?

You may take it with food if stomach upset occurs. Do not crush or chew extended-release tablets. Doing so can release the entire drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so.

Should I take Depakote ER in the morning or at night?

You should take Depakote at a time of day when you can best remember to take it consistently—for instance, in the morning with breakfast or in the evening before you go to bed. Please see Full Prescribing Information with Medication Guide for the complete list of side effects.

What is the recommended dose for Depakote ER?

Depakote ER is indicated for prophylaxis of migraine headaches in adults. The recommended starting dose is 500 mg once daily for 1 week, thereafter increasing to 1,000 mg once daily. As with other valproate products, doses of Depakote ER should be individualized and dose adjustment may be necessary.