Decision support tool: bipolar disorder – is valproate the right treatment for me

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This decision support tool is for women, girls and anyone who could become pregnant, aged between 12 – 55, considering or taking valproate* for bipolar disorder. It has been produced as part of an NHS-wide effort to reduce the use of valproate in people who can get pregnant, and to help those that do continue with valproate to prevent pregnancies.

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The tool is designed to help patients understand the risks and benefits of valproate and support them to start or continue taking it. If sodium valproate is taken during pregnancy, there is a significant risk of harm to the baby as well as later developmental and learning disabilities.

Patients are advised not to make any changes to their treatment, including valproate, without first discussing it with a healthcare professional that knows them and their condition.

In December 2022, the independent Commission on Human Medicines (CHM) advised that no one under the age of 55 should be initiated on valproate unless two specialists independently consider and document that there is no other effective or tolerated treatment. Where possible, existing patients should be switched to another treatment unless two specialists independently consider and document that there is no other effective or tolerated treatment or the risks do not apply. Work is currently ongoing to support the safe introduction of these new measures into clinical practice.

In the meantime, healthcare professionals and patients are urged to consider alternative options to valproate. The new valproate decision support tools will support this.

As the Commission on Human Medicine (CHM) has advised that men under the age of 55 should also be offered the same opportunities as women to have their treatment reviewed, additional versions of the tools will be needed. MHRA are due to release information about this imminently.

*Valproate is also known as: Sodium valproate, Valproic acid, Epilim, EpilimChrono, Epilim Chronosphere, Episenta, Epival, Convulex, Syonell, Belvo, Orlept, Depakote, Dyzantil, Depakin.