Valproate is a teratogen which can cause physical birth defects and developmental disorders in children exposed in utero. It should be avoided in women or girls of childbearing potential (including young girls who are likely to need treatment into their childbearing years) unless other options are ineffective or not tolerated and a pregnancy prevention programme is in place.^7,8

People taking valproate need to be aware of the signs and symptoms of blood and liver disorders and to seek immediate medical help. Valproate should be stopped immediately if abnormal liver function or blood dyscrasia is detected.

Blood count and liver function tests should be done before initiating valproate, after six months and then every 12 months thereafter, along with BMI. If stopping valproate is not an emergency, then the does should be reduced over at least four weeks.