General Side Effects. The side effects given here are associated with valproate. Other antiseizure drugs have similar effects and some specific ones of their own. Most are usually minor, occurring early in therapy and then subsiding. Valproate side effects include:
- Gastrointestinal problems such as nausea, vomiting, and heartburn
- Headaches
- Visual disturbances
- Ringing in the ear
- Hair loss
- Weight gain (a significant problem with valproate)
- Agitation
- Odd movements
- Menstrual irregularities and a higher risk for polycystic ovary syndrome (PCOS)
- Birth defects when taken by pregnant women
- Cognitive impairment and symptoms of Parkinson's disease
Very serious side effects are possible. Stevens-Johnson syndrome (SRS) is a rare but severe and potentially life-threatening, rash that can develop as a side effect of carbamazepine, lamotrigine, oxcarbazepine and other anticonvulsants. Because this is a very serious condition, these drugs are discontinued at the first sign of rash. Other serious side effects, also rare, may include:
- Liver damage
- Convulsions
- Coma
- Pancreatitis
Atypical Antipsychotics
Atypical antipsychotics are standard drugs for schizophrenia. They are now proving to be beneficial for bipolar disorder when used alone or in combination with the mood stabilizers that treat mania. These drugs include clozapine (Clozaril) (the first atypical antipsychotic), olanzapine (Zyprexa), risperidone (Risperdal), quetiapine (Seroquel), aripiprazole (Abilify) and ziprasidone (Geodon).
- Olanzapine was the first atypical antipsychotic approved for treatment of bipolar disorder. In 2000, the FDA approved it to treat bipolar mania and mixed states. In 2004, the drug became the first atypical antipsychotic approved for bipolar maintenance treatment.
- Symbyax, a drug that combines olanzapine and the antidepressant fluoxetine, was approved in 2003 for treatment of bipolar depression.
- Risperidone, ziprasidone, and ariprazole are approved for treatment of bipolar mania and mixed states. Quetiapine is approved for treatment of bipolar mania and bipolar depression, making it the only drug approved for treating both manic and depressive states.
- Clozapine has not yet been approved for treatment of bipolar disorder, but has shown promise in investigative studies. However, this drug has more significant side effects than other atypical antipsychotics. It poses a risk of white blood cell reduction (agranulocytosis) and has the highest risk of weight gain of all atypicals.
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