Rational Use of Valproate: Indications and Drug Regimen in Epilepsy

Sodium valproate (Na VPA) is more often prescribed in European countries than valproic acid (VPA) in the United States for two reasons: Na VPA has been available for clinical use for a longer time, since it was first introduced in France in 1967 and VPA was not authorized for use in the United States until 1978; and in the United States indications for VPA (syrup and capsules) and very recently enteric‐coated tablets of divalproex sodium include only absence seizures accompanied or not by other seizure types. In the majority of European countries, Na VPA (liquid forms and enteric‐coated tablets) may be prescribed in all types of epilepsy. Before outlining the indications and drug regimens of Na VPA/VPA in epilepsy, we shall consider how this drug is presently used in a realistic situation and not in a highly specialized center.