Dosing of Epilim (Valproate) for Mania

Initial Dosing and Titration

An alternative approach for more gradual titration is to start with 125 mg twice daily and titrate upward to therapeutic blood levels, as recommended by the American Academy of Family Physicians 1, 2

The American Academy of Child and Adolescent Psychiatry recommends obtaining baseline liver function tests, complete blood count, and pregnancy test (in females of childbearing potential) before initiating treatment, and continue monitoring hepatic and hematological indices every 3-6 months during maintenance treatment 3

The American College of Emergency Physicians suggests that intravenous valproate loading can be used at doses up to 30 mg/kg at a maximum rate of 10 mg/kg/min for rapid control of acute mania 4

The American Academy of Family Physicians notes that common side effects of valproate include sedation, gastrointestinal disturbances, tremor, and transient liver enzyme elevations, and recommends monitoring for these side effects 1, 2
The American Academy of Family Physicians also recommends monitoring of liver enzymes, platelets, prothrombin time, and partial thromboplastin time as indicated, as valproate is generally better tolerated than other mood stabilizers but requires monitoring 1, 2