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Bipolar disorder

Valproate blood-level monitoring

If you take valproate long-term, a blood valproate level should be checked periodically.

82% of the time this step is missed
1.6x higher risk of harm when missed

The silent should: If you take valproate long-term, a blood valproate level should be checked periodically.

In our analysis of de-identified U.S. psychiatric records, this step was missing 82% of the time it should have happened.

Why it matters: Forward-12mo thrombocytopenia: 1.65x (95% CI 1.27-2.13) for supra-therapeutic or toxic (>=125 ug/mL) vs therapeutic (50-125 ug/mL) valproate levels.

This page is information to help you ask questions — it is not medical advice, and you should never start, stop, or change a medication on your own. Bring these questions to your clinician.

Questions for your doctor the next time you see them

Copy a line and ask it — these are questions, never instructions to change treatment.

  • I take valproate - when was my last valproate blood level?
  • How often should this level be checked?

The evidence

Over the following 12 months, low platelet counts: 1.65x (95% confidence interval 1.27-2.13) for too-high (>=125 ug/mL) vs therapeutic (50-125 ug/mL) valproate levels.

This page is informational and not medical advice. It describes care patterns across a population, not your situation. Bring these questions to a clinician who knows you.

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