Valproic acid is one of the most frequently prescribed mood-stabilizing agents for bipolar disorder, and in some regions of the world, it now competes with lithium as the preferred treatment of choice for bipolar maintenance. There may soon be restrictions on the use of valproic acid, however, because of the risk in neural tube defects and major congenital malformations in children born to mothers and fathers who take it.

In this podcast, Dr. Samuel Dotson, from the Northeast Georgia Health System in Gainesville, Georgia, and Emory University in Atlanta, and Dr. Andrew Nierenberg, from the Dauten Family Center for Bipolar Treatment Innovation at Massachusetts General Hospital and Harvard Medical School, discuss the current state of research regarding the benefits and risks of valproic acid in comparison to lithium use. They also discuss the importance of informing patients about their options, noting that lithium use has sometimes been perceived as riskier than it is. Dr. Dotson and Dr. Nierenberg are the authors of a Guest Editorial titled “Growing Concerns Over Valproate Teratogenicity Present an Opportunity for Lithium” in the March-April 2025 issue of The Journal of Clinical Psychopharmacology.