A SINGLE CASE REPORT ON HYPERAMMONEMIA INDUCED BY VALPROATE MONOTHERAPY WITHOUT HEPATIC DYSFUNCTION

  • C. Prarthana Saraswathi Block No C3, Door No-27, Kendriya Vihar apartments , Sree Balaji Medical College and Hospital, Chrompet, Vellapanchavadi, Chennai-77
  • J. Anu Rita Block No C3, Door No-27, Kendriya Vihar apartments , Sree Balaji Medical College and Hospital, Chrompet, Vellapanchavadi, Chennai-77
  • S. Nambi Block No C3, Door No-27, Kendriya Vihar apartments , Sree Balaji Medical College and Hospital, Chrompet, Vellapanchavadi, Chennai-77

Abstract

Valproate is a commonly used mood stabilizer. One of the important and rare side effects of valproate is hyperammonemia leading to delirium and hepatic encephalopathy. Valproate-induced delirium is commonly mistaken for worsening of manic symptoms or psychosis. We hereby report a case of bipolar affective disorder who was on a therapeutic dose of valproate monotherapy developed altered mental status where we found elevated levels of plasma ammonia which decreased after the discontinuation of valproate and with normal levels of serum valproate, LFT's, EEG and imagings. This case report emphasises on the need to consider plasma ammonia levels in patients with altered mental status receiving valproate in addition to other investigations.

Keywords: Valproate-induced altered mental status, hyperammonemia, plasma ammonia levels

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References

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Saraswathi, C. P., J. A. Rita, and S. Nambi. “A SINGLE CASE REPORT ON HYPERAMMONEMIA INDUCED BY VALPROATE MONOTHERAPY WITHOUT HEPATIC DYSFUNCTION”. International Journal of Pharmacy and Pharmaceutical Sciences, Vol. 9, no. 4, Feb. 2017, pp. 218-9, doi:10.22159/ijpps.2017v9i4.8571.
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Case Study(s)