Chronic valproic acid intoxication: reversal by naloxone.
A 76-year-old woman being treated with sodium valproate for bipolar depression presented with a 4 day history of acute confusion and tremulousness. She had apnoeic episodes, reduced conscious level and generalised myoclonic movements. Her plasma valproate concentration was 848 micromol/l (normal 300-600 micromol/l). Administration of naloxone 0.8 mg led to rapid clinical improvement. Naloxone may be useful in reversing the features of chronic valproate toxicity.
Thanacoody
H K R
HK
Scottish Poisons Information Bureau, Royal Infirmary Edinburgh, 51 Little France Crescent, Edinburgh, UK. ruben.thanacoody@luht.scot.nhs.uk
D000368:Aged; D018692:Antimanic Agents / Q000506:poisoning*; D001714:Bipolar Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D011041:Poisoning / Q000188:drug therapy*; D014635:Valproic Acid / Q000506:poisoning*
D018692:Antimanic Agents; D009292:Narcotic Antagonists; D009270:Naloxone; D014635:Valproic Acid
J Toxicol Clin Toxicol. 2000;38(7):755-60
11192462
Ann Neurol. 1987 Apr;21(4):416-7
3107459
Eur J Pharmacol. 1978 Jan 1;47(1):19-27
618728
Nephrol Dial Transplant. 2001 Jul;16(7):1483-6
11427646