title: Valproate-induced tinnitus misinterpreted as psychotic symptoms.
abstract: Valproate sodium is an anticonvulsant medication, which has also been shown to be effective in the treatment of bipolar disorder. We report a case of valproate-induced tinnitus that was initially misinterpreted as increasing psychotic symptoms, which began approximately 2 days after initiation of valproate therapy. Tinnitus worsened during the next 6 days of treatment until it was recognized that this symptom was related to valproate. After discontinuance of the medication, the tinnitus gradually resolved over a period of 10 days with no residual effects. Although it is a rare adverse effect, valproate-induced tinnitus should be included in the differential diagnosis for tinnitus in patients receiving this medication. Tinnitus may be difficult to recognize in patients with active psychosis or mania.
authors.affiliation: Department of Psychiatry, Montgomery VA Medical Center, USA.
authors.forename: R R
authors.initials: RR
authors.lastname: Reeves
authors.forename: D W
authors.initials: DW
authors.lastname: Mustain
authors.forename: J E
authors.initials: JE
authors.lastname: Pendarvis
mesh_terms: D018692:Antimanic Agents / Q000009:adverse effects*; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D003937:Diagnosis, Differential; D006212:Hallucinations / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014012:Tinnitus / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis*; D014635:Valproic Acid / Q000009:adverse effects*
chemical_list: D018692:Antimanic Agents; D014635:Valproic Acid