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Sodium valproate overdose and poisoning
Valproate overdose causes effects on the CNS, metabolic system and bone marrow.
However, the key thing to remember is that severe sodium valproate toxicity is invariably associated with sedation, so a patient who remains fully alert and well several hours after an overdose is likely to remain so.
Please do subscribe to the channel if you found this interesting and want to learn more
Treatment involves decontamination with charcoal, enhanced elimination with dialysis, and some people like to try carnitine but this last option doesn't really have the evidence base to support its use.
Not medical advice
References:
Ghannoum M, Laliberte M, Nolin TD, MacTier R, Lavergne V, Hoffman RS, et al. Extracorporeal treatment for valproic acid poisoning: systematic review and recommendations from the EXTRIP workgroup. Clin Toxicol (Phila) 2015;53(5):454–65.
Isbister GK, Balit CR, Whyte IM, Dawson A. Valproate overdose: a comparative cohort study of self poisonings. Br J Clin Pharmacol 2003;55(4):398–404.
Perrott J, Murphy NG, Zed PJ. L-carnitine for acute valproic acid overdose: a systematic review of published cases. Ann Pharmacother 2010;44(7–8):1287–93.
Spiller HA, Krenzelok EP, Klein-Schwartz W, Winter ML, Weber JA, Sollee DR, et al. Multicenter case series of valproic acid ingestion: serum concentrations and toxicity [Erratum in J Toxicol Clin Toxicol 2001;39(1):115]. J Toxicol Clin Toxicol 2000;38(7):755–60.
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