Introduction: Valporic acid is anti-epileptic drug used to treat partial and generalized seizures, acute mania, as prophylaxis for bipolar disorder and migraine headaches. The mechanism of action of valporic acid is its ability to potentiate the effect of neurotransmitter Gamma Amino Butyrate (GABA). Valporic Acid intoxication may lead to central nervous system depression, encephalopathy, respiratory depression, hypotension, bone marrow depression, acid base disorders, hypeamonemia, and elevated liver enzymes. Several methods had been suggested to treat Valporic Acid intoxication, like supportive treatment, Naloxone injection, L-carnitine, activated charcoal and hemofiltration.
Case report: An 8 years old epileptic girl, was treated with Valporic Acid syrup drug, was admitted to hospital due to drowsiness, abdominal pain, vomiting and diarrhea. One week before her admission, she was taking three fold the prescribed dose of Valporic Acid as a result of wrong calculation.
Her physical examination and head Computed Tomography were normal. Her blood tests showed that Valporic Acid level was double the upper limit of normal level in blood and a mild elevation of ammonia. After consulting Israel Poison Information Center, she was treated by discontinuing the medicine, supportive treatment and recurrent doses of activated charcoal. The levels of Valporic Acid and ammonia returned to normal along with improvement in her clinical condition.
Conclusion: While cases of chronic Valporic Acid intoxication has been reported, treatment with recurrent doses of activated charcoal was reported only for acute intoxication, we report a case of treatment with recurrent doses of activated charcoal for mild chronic Valporic Acid intoxication.
