Valproate is a commonly prescribed anti-seizure drug inhibiting Na channels and GABA transaminase.

Features of Inroxication include

CNS

• Confusion
• Irritability
• Coma
• Encephalopathy (Hyperammonaemia)

GIT

• Nausea and Vomiting
• Hepatotoxicity (in chronic OD, rarely in acute OD)
• Renal impairment

E’lytes and acid base

• Hypocalcaemia
• Hypernatraemia
• Metabolic acidosis

Diagnosis

Serum levels
monitor frequently to confirm decrease

Management

• ABC
• Mainly supportive
• Whole bowel irrigation
• Multidose charcoal (in particular if slow release)
• Carnitine supplementation
• ? dialysis (however highly protein bound)