UMEM Educational Pearls

Category: Toxicology

Title: Valproic Acid and its Unique Antidote

Keywords: valproic acid, poisoning, carnitine (PubMed Search)

Posted: 10/11/2007 by Fermin Barrueto, MD (Updated: 8/10/2022)
Click here to contact Fermin Barrueto, MD

Valproic Acid (Depakote) - Increased use for both seizure disorder, migraine prophylaxis and bipolar disorder - Causes hyperammonemia with or without hepatic insufficiency (Liver enzymes could be normal!) - Hyperammonemia can occur at therapeutic concentrations and overdose - If the patient is sedated and has hyperammonemia, consider carnitine therapy antidotal - Carnitine IV or PO: 50-100 mg/kg bolus or divided bid, safe to give