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Hi all - just for information. The BNF used to dissuade people from routine valproate monitoring in epilepsy, but I recently noticed that they had changed the relevant section to read: "Sodium valproate has widespread metabolic effects and monitoring is essential" (see BNF 64, page 298). They meant LFT and FBC monitoring, but it wasn't at all clear from the context. I wrote to them about this, and am pleased to say that BNF 65 (March-Sept 2013) now says (bottom of page 302): "Sodium valproate has widespread metabolic effects and monitoring of liver function tests and full blood count is essential.... Plasma valproate concentrations are not a useful index of efficacy, therefore routine monitoring is unhelpful." Small victory - might be useful to some of you in restricting inappropriate requests. Cheers, Mike ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/