Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Valproate(click to collapse)
1/4 selected
Valproate
Depakote · Divalproex sodium
Anticonvulsant/Mood Stabilizer
FDA-approved indications
- Acute manic or mixed episodes in Bipolar I (adults)
- Complex partial seizures — mono or adjunct (adults; pediatric 10+)
- Simple and complex absence seizures (adults; pediatric)
- Multiple seizure types including absence — adjunct (adults; pediatric)
Off-label uses
- Agitation in dementia
- Impulse control disorders
- Neuropathic pain
Half-life9 to 16 hours
Decision GuideWhen to pick each / when to consider an alternative
Valproate
Consider when
- Acute mania or mixed episodes — FDA-approved for mania; rapid-loading strategy (20–30 mg/kg) enables fast onset within days
- Seizure comorbidity with bipolar disorder — broad-spectrum antiepileptic (absence, myoclonic, GTC, partial); dual benefit
- Migraine prophylaxis with mood instability — FDA-approved for migraine prevention; addresses both conditions
- Rapid mood stabilization needed — IV and oral loading available; faster onset than lithium titration or lamotrigine
- +1 more
Consider an alternative when
- Women of childbearing potential — most teratogenic mood stabilizer; neural tube defects 1–2%, IQ reduction 8–10 points; contraindicated in pregnancy for migraine/mania
- Hepatic disease — boxed warning for fatal hepatotoxicity; contraindicated in significant hepatic disease
- Pancreatitis history or risk — boxed warning for life-threatening pancreatitis; can occur at any point during treatment
- Weight gain is a concern — dose-dependent weight gain; worse than lamotrigine or carbamazepine for metabolic profile
- +1 more
| Axis | Valproate anticonvulsant-MS |
|---|---|
| Boxed Warnings | |
Suicidality (boxed warning) | |
DRESS / multiorgan hypersensitivity | |
| CNS | |
Sedation / somnolence | |
Activation / insomnia | |
Cognitive dulling / anterograde amnesia | |
| Metabolic | |
Weight gain | |
Metabolic (glucose / lipids) | |
Hyperammonemia / encephalopathy | |
| GI | |
Nausea / GI (general) | |
| Hepatic | |
Liver enzymes / hepatotoxicity | |
| Safety | |
Bleeding risk | |
Overdose toxicity | |
| Pregnancy | |
Teratogenicity | |
Lactation / breastfeeding safety | |
| Drug-specific / distinctive axes | |
Pancreatitis (BOXED) only in Valproate | |
Alopecia (distinctive) only in Valproate | |
Polycystic ovary syndrome / hyperandrogenism (distinctive — women) only in Valproate | |
Hypothermia (distinctive — W&P 5.11) only in Valproate | |