Document Detail

Valproic acid-associated hyperammonemic encephalopathy: a case report from the psychiatric setting.
MedLine Citation:
PMID:  15602119     Owner:  NLM     Status:  MEDLINE    
Valproic acid-associated hyperammonemic encephalopathy (VHE) has been described in the neurology and emergency medicine literature, but the case reports identified therein are rarely derived from the psychiatric use of this medication. Valproic acid is widely used as a mood stabilizer in bipolar affective disorder and schizoaffective disorder. Patients with normal blood levels, liver function and metabolic tests may present with markedly elevated ammonia and a variety of neurological symptoms. We report the case of a patient on long-term valproic acid therapy, with stable dosing, who presented with an elevated ammonia level, new-onset tremor, confusion, and loss of consciousness. This case illustrates the need to check ammonia levels in psychiatric patients who are taking valproic acid and who present with new neurological symptoms.
Ryan J Kimmel; Scott A Irwin; Jonathan M Meyer
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  International clinical psychopharmacology     Volume:  20     ISSN:  0268-1315     ISO Abbreviation:  Int Clin Psychopharmacol     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2004-12-16     Completed Date:  2005-05-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8609061     Medline TA:  Int Clin Psychopharmacol     Country:  England    
Other Details:
Languages:  eng     Pagination:  57-8     Citation Subset:  IM    
Department of Psychiatry, University of California San Diego, La Jolla, California 92093-0603R, USA.
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MeSH Terms
Antimanic Agents / adverse effects*,  therapeutic use*
Bipolar Disorder / drug therapy*
Brain Diseases / chemically induced*
Confusion / etiology
Hyperammonemia / chemically induced*
Middle Aged
Tremor / etiology
Unconsciousness / etiology
Valproic Acid / adverse effects*,  therapeutic use*
Reg. No./Substance:
0/Antimanic Agents; 99-66-1/Valproic Acid

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