At what age is valproate contraindicated?

Valproate is contraindicated in children aged 2 years and younger primarily due to the risk of serious adverse effects, including hepatotoxicity and pancreatitis, which are more pronounced in this age group. Research indicates that the liver is particularly vulnerable in very young children, and the metabolism of valproate can be erratic, leading to unpredictable and potentially dangerous side effects.

In addition to the hepatic risks, there is an increased risk of developmental issues and cognitive impairment associated with the use of valproate in very young children, especially in those with certain underlying conditions like mitochondrial disorders. This age group is still developing, and the neurotoxic potential of valproate can have lasting implications.

Choosing an age older than 2 may suggest that the medication could be used more safely, though it's important to weigh the risks and benefits even at those ages.