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What is Valproic Acid test?

Valproic acid is an anti-epileptic drug that is generally prescribed to control seizures by reducing their frequency and severity. It is also given to people with bipolar disorder and chronic pain syndrome.
Valproic acid test is recommended in people who are being treated with this medicine to find out if the blood levels of this drug are in the therapeutic range. 

  1. Why is Valproic Acid test performed?
  2. How do you prepare for Valproic Acid test?
  3. How is Valproic Acid test performed?
  4. What do Valproic Acid test results mean?

Valproic acid test is performed at the beginning of valproic acid treatment and is ordered when the duration of the medication is being changed. It is also done at regular intervals during the treatment to ensure that the therapeutic levels of valproic acid in blood remain consistent.
This test is useful (when a person does not respond to valproic acid) to assess if the concentration of the drug is too low to be effective. Doctors also recommend this test when the following side effects of valproic acid are observed:

Valproic acid test does not require any special preparations. However, you should talk to your healthcare practitioner about the timing of sample collection as dosage timing and the type of formulation (for example, time-released formulations) can alter valproic acid levels in the blood. The doctor might recommend sample collection before you take a dose to ensure that the lowest amounts of valproic acid are present in your bloodstream.
Any prescribed and non-prescribed medications, nutritional supplements, vitamins and over-the-counter medications can alter or increase valproic acid concentrations in blood. So, it is best to inform the doctor about these too.

It is a simple test in which a blood sample is withdrawn by drawing blood from a vein in the arm. The sample is collected in a sterile vial or a test tube and sent to a laboratory for analysis. You may feel a momentary pricking pain when the needle goes in the vein.
Also, there is a minimal risk of light-headedness and bruising at the site of injection. However, at most times, these symptoms disappear quickly. Rarely, an infection may occur at the site of withdrawal of blood.

Normal results:

The therapeutic range for both bound and unbound valproic acid has been recorded as 50 to 125 µg/mL.

The therapeutic range for free valproic acid (only unbound) is 6 to 22 µg/mL.

The recommended range for acute mania treatment is 85 to 125 µg/mL and for epilepsy treatment, it is 50 to 100 µg/mL.

If valproic acid levels are within these ranges with no symptoms of migraines, recurrent seizures, mood swings or other side effects, it can be confirmed that the dosage of the drug is adequate.

Abnormal results:

Valproic acid levels higher than the therapeutic range indicate valproic acid toxicity.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.  

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References

  1. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Valproic Acid
  2. National Health Service [Internet]. UK; Valproic acid
  3. AIDSinfo. Valproic Acid. U.S. Department of Health and Human Services. [internet].
  4. National Center for Biotechnology Information. Valproic acid. PubChem Database.CID=3121
  5. US Food and Drug Administration (FDA) [internet]; Depakene (valproic acid) Solution