Elsevier

The Journal of Pediatrics

Volume 101, Issue 5, November 1982, Pages 782-785
The Journal of Pediatrics

Carnitine deficiency and hyperammonemia associated with valproic acid therapy*

https://doi.org/10.1016/S0022-3476(82)80320-XGet rights and content

Plasma carnitine and blood ammonia concentrations were measured in 25 severely handicapped patients, ages 3 to 21 years, and 27 age-matched control subjects. Fourteen of the handicapped patients were treated with anticonvulsant drugs including valproic acid; the remaining 11 patients were treated with drugs excluding valproic acid. Plasma carnitine concentrations were lower and blood ammonia values were higher in patients treated with valproic acid than in the untreated patients and control subjects. A significant inverse relationship was found between plasma carnitine concentrations and the dosage of valproic acid, and between plasma carnitine and blood amonia values. After oral administration of d,l-carnitine (50 mg/kg/day) for four weeks, both carnitine deficiency and hyperammonemia were corrected.

References (15)

There are more references available in the full text version of this article.

Cited by (252)

  • The Roles of Antidotes in Emergency Situations

    2022, Emergency Medicine Clinics of North America
    Citation Excerpt :

    During the process of mitochondrial β-oxidation, VPA depletes carnitine stores. Carnitine supplementation is well tolerated and may be beneficial in acute and chronic valproate exposure.100–104 Additionally, the supplementation of levocarnitine may be beneficial in high-risk patients.99

View all citing articles on Scopus
*

Supported by a grant from the Ministry of Health and Welfare, Japan.

View full text