Since the millennium, valproate has become a front-line treatment for bipolar disorders, with the perception of this being, particularly in comparison to lithium, easier to use for both patients and doctors. In recent years, however, increasing concerns have been raised about high risks of organ dysgenesis and neurodevelopmental disorders following in utero exposure, forcing major regulatory actions. Detailed scrutiny of valproate's extensive actions is, in addition, raising further questions about long-term safety outwith pregnancy, in relation to metabolic, hormonal and possible trans-generational epigenetic effects. This is a crucial and evolving issue in clinical psychopharmacology, the facts of which need to be known to prescribers as specific actions are required to meet the terms of the license. However, in the UK most prescriptions are still for compounds not licensed for use in mood disorders. This session aims to provide an up-to-date overview of the benefit: risk of valproate in current psychiatric practice - the evidence supporting its use, the reasons for regulatory concern and, via large-scale clinical audit, how it is being prescribed and monitored in practice.