Three Patients Needing High Doses of Valproic Acid to Get Therapeutic Concentrations

Joint Authors

de Leon, Jose
Jackson, James
McCollum, Betsy
Ognibene, Judy
Diaz, Francisco J.

Source

Case Reports in Psychiatry

Issue

Vol. 2015, Issue 2015 (31 Dec. 2015), pp.1-12, 12 p.

Publisher

Hindawi Publishing Corporation

Publication Date

2015-04-27

Country of Publication

Egypt

No. of Pages

12

Main Subjects

Psychology
Medicine
Psychiatry

Abstract EN

Valproic acid (VPA) can autoinduce its own metabolism.

Cases requiring VPA doses >4000 mg/day to obtain therapeutic plasma concentrations, such as these 3 cases, have never been published.

Case 1 received VPA for seizures and schizophrenia and had >50 VPA concentrations in 4 years.

A high dose of 5,250 mg/day of VPA concentrate was prescribed for years but this dose led to an intoxication when switched to the enterocoated divalproex sodium formulation, requiring a normal dose of 2000 mg/day.

VPA metabolic capacity was significantly higher (t=-9.6; df = 6.3, p<0.001) during the VPA concentrate therapy, possibly due to autoinduction in that formulation.

Case 2 had VPA for schizoaffective psychosis with 10 VPA concentrations during an 8-week admission.

To maintain a VPA level ≥50 μg/mL, VPA doses increased from 1500 to 4000 mg/day.

Case 3 had tuberous sclerosis and epilepsy and was followed up for >4 years with 137 VPA concentrations.

To maintain VPA concentrations ≥50 μg/mL, VPA doses increased from 3,375 to 10,500 mg/day.

In Cases 2 and 3, the duration of admission and the VPA dose were strongly correlated (r around 0.90; p<0.001) with almost no change after controlling for VPA concentrations, indicating progressive autoinduction that increased with time.

American Psychological Association (APA)

Jackson, James& McCollum, Betsy& Ognibene, Judy& Diaz, Francisco J.& de Leon, Jose. 2015. Three Patients Needing High Doses of Valproic Acid to Get Therapeutic Concentrations. Case Reports in Psychiatry،Vol. 2015, no. 2015, pp.1-12.
https://search.emarefa.net/detail/BIM-1059841

Modern Language Association (MLA)

de Leon, Jose…[et al.]. Three Patients Needing High Doses of Valproic Acid to Get Therapeutic Concentrations. Case Reports in Psychiatry No. 2015 (2015), pp.1-12.
https://search.emarefa.net/detail/BIM-1059841

American Medical Association (AMA)

Jackson, James& McCollum, Betsy& Ognibene, Judy& Diaz, Francisco J.& de Leon, Jose. Three Patients Needing High Doses of Valproic Acid to Get Therapeutic Concentrations. Case Reports in Psychiatry. 2015. Vol. 2015, no. 2015, pp.1-12.
https://search.emarefa.net/detail/BIM-1059841

Data Type

Journal Articles

Language

English

Notes

Includes bibliographical references

Record ID

BIM-1059841