Hyperammonemic Encephalopathy due to Valproic Acid and Topiramate Interaction | Zendy

Jennifer D. Twilla | Zendy; Andrew S. Pierce | Zendy

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Hyperammonemic Encephalopathy due to Valproic Acid and Topiramate Interaction

Author(s) -

Jennifer D. Twilla,

Andrew S. Pierce

Publication year - 2014

Publication title -

case reports in psychiatry

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.17

H-Index - 4

eISSN - 2090-682X

pISSN - 2090-6838

DOI - 10.1155/2014/410403

Subject(s) - medicine , valproic acid , hyperammonemia , topiramate , lactulose , adverse effect , polypharmacy , encephalopathy , pediatrics , pharmacovigilance , anticonvulsant , anesthesia , pharmacology , gastroenterology , epilepsy , psychiatry

Valproic acid-induced hyperammonemic encephalopathy is a rare yet serious adverse drug reaction. Medication interactions such a valproic acid and topiramate can precipitate an event. We present the case of a 52-year-old female that presented with acute mental status change and hypersomnolence due to hyperammonemia caused by a valproic acid derivative. The patient improved after withdrawal of the offending medications and treatment with lactulose. Clinicians should remain hypervigilant in monitoring for valproic acid-induced hyperammonemic encephalopathy and risk factors such as polypharmacy.

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