Abstract
Background
Valproic acid (VPA) is a common antiepileptic drug that is also used routinely for
various psychiatric disorders. VPA toxicity typically manifests as central nervous
system depression, while hyperammonemic encephalopathy and hepatotoxicity are potentially
life-threatening complications.
Case Report
We describe the case of a 56-year-old man who presented to the emergency department
after an intentional VPA overdose, was found to have hyperammonemia, and was treated
with L-carnitine exclusively. He was subsequently admitted to the hospital for monitoring
and serial laboratory testing.
Why Should an Emergency Physician Be Aware of This?
Although VPA toxicity has conventionally been managed by gastric decontamination,
L-carnitine, and, in severe and refractory cases, extracorporeal removal, recent literature
supports the use of carbapenem antibiotics, particularly meropenem. Thus, we report
the details of current treatment modalities for VPA toxicity by reviewing current
literature.
Keywords
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References
FDA drug approval database of valproic acid: approval date(s) and history, letters, labels, reviews for NDA 018081. Accessed January 12, 2022. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=018081.
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Article info
Publication history
Published online: July 18, 2022
Accepted:
July 9,
2022
Received in revised form:
May 24,
2022
Received:
March 8,
2022
Identification
Copyright
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