Open AccessA SINGLE CASE REPORT ON HYPERAMMONEMIA INDUCED BY VALPROATE MONOTHERAPY WITHOUT HEPATIC DYSFUNCTION
Author(s) -
C. Prarthana Saraswathi,
J. Anu Rita,
Siva Nambi
Publication year - 2017
Publication title -
international journal of pharmacy and pharmaceutical sciences/international journal of pharmacy and pharmaceutical sciences
Language(s) - English
Resource type - Journals
eISSN - 2656-0097
pISSN - 0975-1491
DOI - 10.22159/ijpps.2017v9i4.8571
Subject(s) - hyperammonemia , discontinuation , delirium , medicine , valproic acid , psychosis , mood stabilizer , bipolar disorder , mood , encephalopathy , therapeutic plasma exchange , pediatrics , psychiatry , anesthesia , epilepsy
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.