Table 2: Side effects and prevalence. List of classified side effects observed during treatment with VPA. NA: Data not available.

Mild side-effectsPrevalence

 Decrease of sleep duration after the end of treatment15 to 45 min/day [126]
 Weight gain14% change of weight class [127, 128]
 DrowsinessNA
 NauseaNA
 UnsteadinessNA
 Decrease appetiteNA

Fertility and teratogenic effectsPrevalence

 Decrease of fertility25% [129]

 Spina bifida3-fold increase [130132]
 Anencephaly
 Cardiac defect
 Dysmorphic features
 Valproate syndrome (decrease of intrauterine growth)
 Craniofacial, skeletal, or limb defect

 Problem of communication developmentNA
 Autism spectrumNA [132]
 Decrease of IQ9 points [133, 134]
 Disorder or decrease of verbal intelligenceNA

Neurological side-effectsPrevalenc

 Ischiemic stroke (if associated with MTHFR mutation: 5–22% of population)1 case reported [135]
 EnchephalopathyNA [120]
 Exacerbation of epilepsy1 case reported [136]
 Parkinsonism1.37–5.04% [137]

Liver damagesPrevalence

 Child hepatotoxicity0.16% [138, 139]

Hematopoietic damagesPrevalence

 Thrombocytopenia4% [120]
 Platelet dysfunction
 Factor XIII deficiency
 Hypofibrinogenemia
 Vitamin K dependent factor deficiency

 von Wilbrant disease67% in children 16% in adults [120]
 Aplastic anemia9-fold increase [140]