From the Research
Depakote (valproic acid/divalproex sodium) does not typically cause hypernatremia, and instead, is more commonly associated with hyponatremia due to its potential to cause syndrome of inappropriate antidiuretic hormone secretion (SIADH) 1. The medication primarily affects GABA neurotransmission in the brain and has multiple mechanisms of action for treating seizures, bipolar disorder, and migraines. Depakote's known electrolyte disturbances include potential hyponatremia (low sodium), which would lower sodium levels rather than raise them. Some key points to consider when evaluating the potential for hypernatremia in patients on Depakote include:
- The more common side effects of Depakote, such as gastrointestinal disturbances, weight gain, hair loss, tremor, liver enzyme elevations, thrombocytopenia, and pancreatitis, do not typically include hypernatremia 1.
- If a patient on Depakote develops hypernatremia, other causes should be investigated, such as dehydration, diabetes insipidus, excessive sodium intake, or other medications 2.
- Regular monitoring of electrolytes is recommended for patients on Depakote, but specifically watching for hypernatremia is not a standard concern with this medication 3. It is essential to note that while Depakote may not typically cause hypernatremia, it can cause renal tubular dysfunction, particularly in patients who are bedridden or have low serum levels of free carnitine and phosphorus 3. Therefore, urinary β2-microglobulin (BMG) should be measured regularly in all patients receiving Depakote to assess renal tubular function, and an additional measurement of serum free carnitine level should be considered in patients who develop renal tubular dysfunction 3.