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The exact mode of action of valproate is unclear. It inhibits enzymes that inactivate GABA, which causes an increase in GABA content of the brain and it possibly enhances the action of GABA. Side effects of valproate are few.

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Small diameter neurons are more susceptible than larger diameter neurons and unmyelinated neurons more than myelinated neurons. Fortunately, neurons that carry the sensation of pain are of the smallest diameter unmyelinated and myelinated type and as such are affected by low doses of local anaesthetic, leaving larger motor neurons unaffected. Complications can arise because of technical errors such as broken needles or practitioner error, for example injection of the wrong solution or accidental injection into a blood vessel. There is always a risk of infection with techniques that puncture the skin.

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