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.
Erythema Nodosum* ; Erythema* ; Valproic Acid*

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

No abstract available.
Bipolar Disorder ; Hair ; Valproic Acid

PURPOSE: Epileptic patients under prolonged treatment with anticonvulsants such as valproate tend to have low serum carnitine level. The object of this study is to observe the interrelationship between anticonvulsants and serum carnitine level and its related symptoms. METHODS: We measured the serum carnitine levels in 31 epileptic patients (18 males, 13 females) receiving diverse antiepileptic drugs and 32 healthy children (20 males, 12 females) using enzymatic cycling method. RESULTS: 1) Among the control group, total, free, and acyl-carnitine in serum were 50.04+/-11.44, 37.42+/-11.13, and 13.98+/-7.49micro mol/L (mean+/-S.D.), respectively, and no significant differences were observed between age and sex. 2) Among 31 patients with treatment, total serum carnitine level and free carnitine level below 2 standard deviation from the mean control value was not observed. 3) Among 31 patients with treatment, total serum carnitine level below 2 standard deviation from the age matched mean control value was not observed. 4) No significant relationship was observed between the serum carnitine level and the dosage, duration and the serum concentration of the antiepileptic drugs. 5) There were no abnormalities in serum AST, ALT levels among the patients treated. CONCLUSION: Although our study didn't reveal that serum carnitine level can be lowered in patients treated with anticonvulsants such as valproate, many others reported it. So periodic measurement of serum carnitine level before and after treatment with anticonvulsants should be considered.
Anticonvulsants* ; Carnitine* ; Child* ; Humans ; Male ; Valproic Acid

PURPOSE: To evaluate the efficacy of vigabatrin and valproic acid add-on therapy in the treatment of uncontrolled partial-onset seizures through randomized active controlled parallel-group trial. METHODS: Criteria for entry included a requirement for three or more partial seizures per month despite the blood level of carbamazepine was within therapeutic range. During the 56-day baseline period, patients had at least 6 partial onset seizures. Vigabatrin or valproic acid were administered as the second drug in a randomized fashion. RESULTS: Forty one patients completed the trial(21 for vigabatrin, 20 for valproic acid). There is no statistically significant difference in age, age at onset, baseline seizure frequency, dose of carbamazepine, and serum level of carbamazepine between two groups. Two patients of vigabatrin-treated group and three patients of valproic acid treated group were dropped out because of side effects. The mean vigabatrin and valproic acid does were 2809 and 1490 mg, respectively. The percentage of patients achieving at least a 50% reduction in seizure frequency at the end of 8-week of add-on trial was 62% among vigabatrin-treated patients and was 50% for patients who received valproic acid(not statistically different). There was no significant difference in seizure reduction, percent seizure reduction, and truncated percent seizure reduction between two groups. The side effects were mild and transient neurotoxic symptoms in the patients who completed the trial(5 patients for vigabatrin, 10 patients for valproic acid). CONCLUSIONS: This trial indicates that vigabatrin and valproic acid are safe and effective in the treatment of intractable partial-onset seizures. The efficacy of vigabatrin as a new add-on antiepileptic drug is comparable to the previous valproic acid carbamazepine combination in the sense of seizure reduction and maybe even superior to that in the consideration of side effects
Carbamazepine* ; Humans ; Seizures* ; Valproic Acid* ; Vigabatrin*

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*