ABSTRACT:In this study, spectroscopic and chromatographic evidence is presented for the identification and characterization of the metabolites, valproyl glutamate (2-propylpentanoyl glutamate, VPA-GLU) and valproyl glutamine (2-propylpentanoyl glutamine, VPA-GLN) in the urine, serum, and cerebrospinal fluid (CSF) of patients on valproic acid (VPA) therapy. Moreover, the identification of valproyl glycine (2-propylpentanoyl glycine, VPA-GLY) in the serum and urine of patients on VPA, albeit in trace concentrations, is also reported here. The three amino acid conjugates excreted in urine accounted for about 1% of the VPA dose in four patients who were on VPA therapy chronically and had reached steady state. VPA-GLU was quantitatively the most prominent metabolite (0.66-13.1 g/mg creatinine) compared with VPA-GLN (0.78-9.93 g/mg creatinine) and VPA-GLY (trace-1.0 g/mg creatinine) in overnight urine samples of all patients studied (n ؍ 29). The relatively low serum concentrations of the three amino acid conjugates of VPA in six patients suggest that the metabolites are readily excreted once formed. In contrast, whereas VPA GLY was absent in the CSF of one patient on VPA, the concentrations of VPA-GLU and VPA-GLN in this CSF sample were 9 and 5 times, respectively, their corresponding serum concentrations.The antiepileptic drug, valproic acid (VPA 3 ), is primarily used for the management of generalized and absence seizures in children. Concerns over its teratogenicity and hepatotoxicity side effect have encouraged the need to develop analogs of VPA devoid of the adverse effects. However, this task is complicated by the fact that the mechanism of action of the drug itself remains to be understood.A large body of evidence has emerged to link the hepatotoxicity of VPA to its metabolism and has been reviewed over the years (Eadie et al., 1988;Abbott and Anari, 1999;Radatz and Nau, 1999). Moreover, a review of mass-balance studies indicated that the total recovery of a VPA dose cannot be completely accounted for in humans (Baillie and Sheffels, 1995), suggesting the existence of yet unknown metabolites. For all these reasons, despite the extensive work that has been conducted on the metabolism of VPA, the subject remains an area that warrants further investigation.