No abstract available.
Valproic Acid*

No abstract available.
Animals ; Mice* ; Valproic Acid*

Valproic acid intoxication is a fairly common clinical problem that can result in serious complications. Traditionally the treatment of valproic acid overdose has been limited to supportive measures, but high blood levels may require extracorporeal removal, and publications on this experience are scarce. This case demonstrated continuous veno-venous hemodiafiltration successfully used in patient with severe valproic acid overdose who was hemodynamically unstable.
Hemodiafiltration ; Humans ; Valproic Acid

No abstract available.
Bipolar Disorder* ; Hair* ; Valproic Acid*

No abstract available.
Erythema Nodosum* ; Erythema* ; Valproic Acid*

No abstract available.
Bipolar Disorder ; Hair ; Valproic Acid

PURPOSE: The purpose of this study is to review the evidence comparing the efficacy and safety between L-carnitine and extracorporeal elimination therapy in the management of acute valproic acid L-carnitine vs Extracorporeal Elimination for Acute Valproic acid Intoxication METHODS: PubMed, Embase, Cochrane library, Web of Science, KoreaMed, KMbase, and KISS were searched, using the terms carnitine and valproic acid. All studies, regardless of design, reporting efficacy or safety endpoints were included. Reference citations from identified publications were reviewed. Both English and Korean languages were included. Two authors extracted primary data elements including poisoning severity, presenting features, clinical management, and outcomes. RESULTS: Thirty two articles including 33 cases were identified. Poisoning severity was classified as 3 mild, 11 moderate, and 19 severe cases. Nine cases were treated with L-carnitine while 24 cases received extracorporeal therapy without L-carnitine. All patients except one expired patient treated with hemodialysis recovered clinically and no adverse effects were noted. A case report comparing two patients who ingested the same amount of valproic acid showed increased ICU stay (3 vs 11 days) in case of delayed extracorporeal therapy. CONCLUSION: Published evidence comparing L-carnitine with extracorporeal therapy is limited. Based on the available evidence, it is reasonable to consider L-carnitine for patients with acute valproic acid overdose. In case of severe poisoning, extracorporeal therapy would also be considered in the early phase of treatment.
Carnitine* ; Humans ; Poisoning ; Renal Dialysis ; Valproic Acid*

BACKGROUND: CEDIA is a newly developed method for therapeutic drug monitoring (TDM) and has some merits such as easy application to routine chemical analyzers, rapid and precise quantitation even in low concentrations and less cross reactivity. We evaluated the CEDIA(epsilon) (Microgenics Co., CA, USA) in measurement of theophyllin, valproic acid and phenytoin levels using 502X(epsilon) (A & T, Tokyo, Japan) and compared the results to those of the TDx(epsilon) (Abbott Laboratories, IL, USA) in order to assess the utility of the CEDIA(epsilon). METHODS: We evaluated the performance of 502X(epsilon) in the aspects of the within-runs and the between-runs precision, linearity, and carry-over. We compared the results of the CEDIA(epsilon) reagent with those of TDx(epsilon). The control materials (Bio-Rad TDM control level 1 and level 3; Bio-Rad laboratories, CA, USA) and clinical specimens were used for these studies. RESULTS: The coefficients of variation (CV) for the within-run and the between-run imprecision of 502X(epsilon) were 2.0-7.6% and 4.0-6.5%, respectively. The carry-over rate for theophyllin, valproic acid and phenytoin was 1.33%, 0.45% and 0.53%, respectively. The linearity (r(2)) of theophyllin, valproic acid and phenytoin was 0.9941, 0.9983 and 0.9947, respectively. The correlation coefficients (r) of theophyllin, valproic acid and phenytoin levels of CEDIA(epsilon), with those determined by the TDx(epsilon), were 0.9730, 0.9703 and 0.9695, respectively (P<0.001). CONCLUSIONS: The recentlydeveloped CEDIA(epsilon) proved to be highly precise and linear for quantitative analysis of theophyllin, phenytoin and valproic acid. Correlations with TDx(epsilon) were significantly high. CEDIA(epsilon) was thought to be clinically useful for TDM.
Drug Monitoring ; Phenytoin* ; Theophylline* ; Valproic Acid*

The anticonvulsant lamotrigine has been reported to be efficacious and well tolerated in treatment of bipolar patients. Recently, its efficacy in rapid cycling states has attracted interest, however there was no reports about lamotrigine in treatment of ultra-rapid cycling bipolar disorder. Here we present the case of a male patient with bipolar disorder who developed an ultra-rapid cycling state. The addition of lamotrigine to prior valproate treatment succeeded to improve the ultra-rapid cycling.
Bipolar Disorder* ; Humans ; Male ; Valproic Acid

Posthypoxic myoclonus is poorly controlled with current treatments. Based on clinical experience, valproate and benzodiazepines have been used to treat myoclonic seizures. Rarely, some antiepileptic drugs may exacerbate myoclonic seizures. Although lamotrigine is controversial for treatment in myoclonic seizures, we experience a case of posthypoxic myoclonus improved with lamotrigine add-on therapy.
Anticonvulsants ; Benzodiazepines ; Myoclonus* ; Seizures ; Valproic Acid