Document Detail


Hyperammoneic encephalopathy, valproic acid, and benzodiazepine withdrawal: a case series.
MedLine Citation:
PMID:  20337505     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Benzodiazepine withdrawal is accompanied by a risk of seizures, delirium, and death. While a gradual outpatient taper off of benzodiazepines is the most commonly recommended method for discontinuation, acute inpatient detoxification and seizure prophylaxis may be necessary for some. Complications related to the use of valproic acid for seizure prophylaxis are presented.
OBJECTIVES: The study's objectives are to highlight an uncommon and possibly unrecognized complication of valproic acid when used for seizure prophylaxis during acute inpatient detoxification from benzodiazepines in the context of current practice.
METHODS: Case series.
RESULTS: Three patients with hyperammoneic encephalopathy are described.
CONCLUSIONS: Hyperammoneic encephalopathy can occur as a distinct entity separate from hepatotoxicity with the use of valproic acid and may be an unrecognized complication among patients receiving this drug during benzodiazepine detoxification.
SCIENTIFIC SIGNIFICANCE: A previously unreported complication among the addiction patient population is reported. This underscores the need for a better evidence base regarding the prevention of seizures during acute benzodiazepine detoxification, particularly in terms of indications, safety, and efficacy.
Authors:
Jacquelyn Starer; Grace Chang
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The American journal of drug and alcohol abuse     Volume:  36     ISSN:  1097-9891     ISO Abbreviation:  Am J Drug Alcohol Abuse     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-26     Completed Date:  2010-06-14     Revised Date:  2011-08-25    
Medline Journal Info:
Nlm Unique ID:  7502510     Medline TA:  Am J Drug Alcohol Abuse     Country:  England    
Other Details:
Languages:  eng     Pagination:  98-101     Citation Subset:  IM    
Affiliation:
Faulkner Hospital Addiction Recovery Program, Boston, Massachusetts 02130, USA. jstarer@partners.org
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MeSH Terms
Descriptor/Qualifier:
Benzodiazepines / adverse effects*
Brain Diseases, Metabolic / chemically induced*
Drug Administration Schedule
Female
GABA Agents / adverse effects,  therapeutic use
Humans
Hyperammonemia / chemically induced*
Male
Middle Aged
Substance Abuse Treatment Centers
Substance Withdrawal Syndrome / drug therapy*
Substance-Related Disorders / drug therapy
Treatment Outcome
Valproic Acid / adverse effects*,  therapeutic use
Grant Support
ID/Acronym/Agency:
K24 AA000289-09/AA/NIAAA NIH HHS; K24 AA00289/AA/NIAAA NIH HHS
Chemical
Reg. No./Substance:
0/GABA Agents; 12794-10-4/Benzodiazepines; 99-66-1/Valproic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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