title: [Hemoperfusion in the treatment of acute valproic acid intoxication].
abstract: Valproic acid is increasingly used in the treatment of epilepsy, and also prescribed for bipolar affective disorders, schizoaffective disorders, schizophrenia and migraine prophylaxis. Valproic acid intoxication with suicide attempt is a relatively common clinical problem that can result in coma, respiratory depression, pancytopenia, hemodynamic instability and death. The drug's relatively low molecular weight, small volume of distribution and saturable protein-binding render it potentially amenable to exracorporeal removal (hemodialysis, hemoperfusion or hemofiltration ), but published experience is scarce. We describe a case report involving valproic acid intoxication with ingestion of ethanol, who was successfully treated with charcoal hemoperfusion. With this treatment the half-life of valproic acid was reduced with rapid lowering of valproic acid levels and clinical improvement. Based on our experience in this patient and a review of previously reported cases, charcoal hemoperfusion should be considered for serious valproic acid intoxication because free as well as bound drug fractions are eliminated via this technique.
authors.affiliation: Servicio de Nefrología, Hospital Universitario La Paz, Madrid, Spain. cpeces@varnet.com
authors.forename: R
authors.initials: R
authors.lastname: Peces
authors.forename: E J
authors.initials: EJ
authors.lastname: Fernández
authors.forename: R J
authors.initials: RJ
authors.lastname: Sánchez
authors.forename: C
authors.initials: C
authors.lastname: Peces
authors.forename: A
authors.initials: A
authors.lastname: Montero
authors.forename: R
authors.initials: R
authors.lastname: Selgas
mesh_terms: D000328:Adult; D018692:Antimanic Agents / Q000506:poisoning; D062787:Drug Overdose / Q000628:therapy; D005260:Female; D006464:Hemoperfusion; D006801:Humans; D013406:Suicide, Attempted; D014635:Valproic Acid / Q000506:poisoning*
chemical_list: D018692:Antimanic Agents; D014635:Valproic Acid