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consider discontinuation of valproate therapy (5.6, 5.9, 5.10) Hypothermia: Hypothermia has been reported during valproate therapy with occur in patients using concomitant topiramate (5.11) Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)/Multiorgan Hypersensitivity Reactions, serious dermatologic reactions, and angioedema: Discontinue Depakote unless an alternate etiology is established (4, 5.12, 5.13, 5.14) Adverse Reactions/Side Effects Most common adverse reactions (reported 15% for any indication) are abdominal pain, alopecia, asthenia, diarrhea, diplopia, dizziness, headache, infection, insomnia, nausea, somnolence, thrombocytopenia, tremor, vomiting (6.1, 6.2, 6.3)

doi: 10.1016/j.eururo.2007.04.042

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Note that both phenytoin and valproic acid may cause adverse neurologic effects at supratherapeutic levels