Acute Valproic Acid Intoxication: An Attempt at Estimating the Correlation Between Serum Level and Clinical Manifestations

Abstract

We investigated the association between serum valproic acid (VPA levels and clinical conditions in patients after acute intoxication with this drug. We performed a retrospective study of cases of VPA intoxications hospitalized in Toxicology Unit in Cracow in years of observation. The study included patients (age . ± .years . In all patients, the VPA plasma level was higher than the therapeutic range, mean ± SD . ± . μg/ml. About half of poisoned patients described in this report were treated with VPA prior to the poisoning. We noted four cases of mixed VPA intoxications with ethanol. Acute pulmonary failure was observed in two persons.The mean hospital stay for all patients was . days. This analysis demonstrates that increased serum VPA levels, in acute intoxication with this drug, were associated with the severity of poisoning -in PSS (P = . and in Mathews coma scale (P = . , diastolic pressure (P = . and length of stay in hospital (P = .. No correlation was detected between the serum VPA concentration and the heart rate and systolic blood pressure. In persons treated with VPA earlier, the course of poisoning was less severe, although these results were not statistically signiicant.

Carbapenems as Antidotes for the Management of Acute Valproic Acid Poisoning

“…When it comes to VPA poisoning, it was shown that, in such scenarios, the half-life of this medication can increase two- to three-fold, being greater than 30 h [ 30 , 31 ]. This implies that the toxic effect of VPA lasts longer in patients in whose treatment carbapenems were not included, thereby having a negative influence on the duration of treatment [ 32 , 33 ] and its outcomes, and primarily the extent of potential complications that could stem from prolonged toxicity [ 34 , 35 ]. Taking into consideration the abovementioned facts, our carbapenem of choice in ten out of eleven patients was meropenem.…”