OBJECTIVES Characteristics such as tablet size and ease-of-swallowing can affect patients' treatment preference, and could in turn affect patient medication compliance. The objectives of this research were to determine the degree to which swallowing Valproate (VP) tablets is an issue, and the predictors of patient preference. METHODS We conducted a quantitative telephone survey of adults (n=400, ≥18 years old) who currently take (n=236) or previously took (n=164) VP tablets within the past 6 months (125 mg, 250 mg, or 500 mg). After online recruitment and screening, eligible participants completed a structured interview about medication use, perceived tablet characteristics, and preferences. Multivariate regression analyses were conducted to determine predictors of treatment preference. RESULTS Respondents took an average 2.5 (SD=1.23) VP tablets/day primarily to treat bipolar disorder (65.0%, n=260), migraine (12.5%, n=50), or epilepsy (11.7%, n=47). More than half of the patients indicated that VP tablets were 'uncomfortable to swallow' (68.5%, n=274) and were 'very interested' (65.8%, n=263) in medications that were easier to swallow. When choosing conceptually between taking their VP tablet once/day or an equally safe and effective but significantly smaller soft gel capsule twice/day, the majority (82.8%, n=331) preferred the soft gel capsule. In the multivariate regression analysis, perceiving soft gel capsules to be easier to swallow (OR = 73.54; 95% CI = 15.01-360.40) and taking VP more frequently (OR = 2.02; 95% CI = 1.13-3.61) were significant predictors of soft gel capsule treatment preference. CONCLUSIONS In this survey-based study, users of VP would prefer a formulation that is easier to swallow. A higher patient preference may improve medication compliance. When choosing between medications with similar efficacy and safety, physicians can consider patient preferences for specific tablet characteristics to optimize conditions for medication compliance. Further research is warranted to examine compliance with medications that are easier to swallow.