Sodium Valproate Induced Hyperammonaemia without Hepatic Failure in Adults: A Series of Three Cases
Published: February 1, 2018 | DOI: https://doi.org/10.7860/JCDR/2018/30892.11221
Vybhav Krishna, Sereen Rose Thomson, Bharti Chogtu, Ganga Parameshwari Soundarrajan, PSVN Sharma
1. Postgraduate Student, Department of Pharmacology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, India.
2. Postgraduate Student, Department of Pharmacology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, India.
3. Associate Professor, Department of Pharmacology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, India.
4. Postgraduate Student, Department of Pharmacology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, India.
5. Professor and Head, Department of Psychiatry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Udupi, Karnataka, India.
Correspondence
Dr. Bharti Chogtu,
Associate Professor, Department of Pharmacology, Kasturba Medical College, Manipal Academy of Higher Education,
Manipal-576104, Karnataka, India.
E-mail: bharti.magazine@manipal.edu
Valproate is an antiepileptic drug that is most commonly prescribed because of its wide spectrum of antiepileptic activity. It is used for the treatment of many psychiatric conditions such as bipolar disorder, schizoaffective disorder, social phobias etc. Valproate is associated with modest elevation of plasma ammonia levels. Some of the risk factors associated with this are poor nutritional intake, antiepileptic polypharmacy, febrile conditions which are thought to deplete L-carnitine levels. Hence, it is important to monitor the plasma ammonia levels at intervals before the patient could develop hyperammonaemic encephalopathy. We hereby report a series of three cases of patients who developed hyperammonaemia following the intake of Sodium Valproate.
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