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Liver failure; Pancreatitis (these two usually occur in first 6 months and can be fatal); Leukopenia (low white blood cell count); Neutropenia (low neutrophil count); Pure red cell aplasia
In general, serum or plasma valproic acid concentrations are in a range of 20–100 mg/L during controlled therapy, but may reach 150–1500 mg/L following acute poisoning. Monitoring of the serum level is often accomplished using commercial immunoassay techniques, although some laboratories employ gas or liquid chromatography. [ 47 ]
Minor limb malformations seen after valproate exposure. Fetal valproate spectrum disorder (FVSD), previously known as fetal valproate syndrome (FVS), is a rare disease caused by prenatal exposure to valproic acid (VPA), a medication commonly used to treat epilepsy, bipolar disorder, and migraines.
When ammonia levels rise greater than 200 μmol/L, serious symptoms, including seizures, encephalopathy, coma, and even death, can occur. [3] Hyperammonemia with blood ammonia levels greater than 400 to 500 μmol/L is associated with 5- to 10-fold higher risk of irreversible brain damage.
Valproic acid, and its derivatives such as sodium valproate and divalproex sodium, causes cognitive deficit in the child, with an increased dose causing decreased intelligence quotient and use is associated with adverse neurodevelopmental outcomes (cognitive and behavioral) in children.
Valproic acid may have direct toxic effect on the pancreas. [21] Various oral hypoglycemic agents are associated with pancreatitis including metformin, but glucagon-like peptide-1 mimetics such as exenatide are more strongly associated with pancreatitis by promoting inflammation in combination with a high-fat diet. [22]
And as with lamotrigine, there are many anecdotal reports of clonazepam greatly decreasing symptoms at >1.5 mg doses [47] Other medical drugs that people have reported some symptom reduction with are the anticonvulsants gabapentin, levetiracetam and valproic acid.
anticonvulsants (phenobarbital, phenytoin, carbamazepine, lamotrigine, and valproic acid). [13] [11] TEN has also been reported to result from infection with Mycoplasma pneumoniae or dengue virus. Contrast agents used in imaging studies as well as transplantation of bone marrow or organs have also been linked to TEN development. [13] [6]