Depakote (divalproex sodium) can be effective against many types of seizures common in children:

• absence seizures-Depakote is just as effective as Zarontin (ethosuximide), and these two medicines also can be used together.
• myoclonic seizures in teens, including juvenile myoclonic epilepsy
• generalized tonic-clonic seizures, such as those in Lennox-Gastaut syndrome.
• infantile spasms (West syndrome)
• photosensitivity (seizures triggered by flashing lights)

Children under 2 or 3 years of age who take Depakote have a much higher risk of liver failure than adults or older children. (The risk is very low for children over 10, perhaps 1 in 50,000.) The risk is even higher for very young children who also take other seizure medicines, and it's highest of all for those with certain other serious disorders. Usually the doctor will not prescribe Depakote for children at very high risk. Liver damage usually occurs within the first 6 months of treatment. The first symptoms of it are vomiting, loss of appetite, sluggishness, and perhaps loss of seizure control, jaundice, or swelling. Some doctors recommend carnitine supplements (100 mg/kg/day) for infants and young children who take Depakote, especially if they have other risk factors for liver damage.

Higher-than-usual levels of the hormone testosterone have been found in many girls who take Depakote when they're older than about age 10. No symptoms are apparent, but the doctor may want to watch for later problems, perhaps related to weight gain.

Occasionally behavioral changes such as irritability are reported in children who take Depakote, but this is seldom a serious problem.

To keep side effects at a minimum, the doctor probably will prescribe a low dose of Depakote to start and increase it slowly. Children usually start with a dose of 5 to 10 milligrams (mg) for each kilogram (kg, about 2.2 pounds) of their body weight per day. This is usually given in two to four equal doses.

Most children do best at about 15 to 60 mg/kg per day. Children taking a combination of Depakote and another seizure medicine usually need the higher doses because of interactions between the medicines.

The sprinkle capsule is an easy way to give Depakote to small children who cannot swallow tablets. The medicine is absorbed by the body a bit more quickly than when tablets are used, but the amount absorbed is the same.